Individual provider Active NPI

Sandy Pena, LCSW

  • Clinical Social Worker
  • Palmdale, CA
National Provider Identifier
1902455827
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW90759 Issued in CA
Practice address
2151 E Palmdale Blvd
Palmdale, CA 93550-4037
Phone
(661) 942-2391
NPI assigned
Sep 4, 2019
Last updated
Sep 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW90759 CA Primary

Addresses

Primary practice location

2151 E Palmdale Blvd
Palmdale, CA 93550-4037

Mailing address

45104 10TH St W
Lancaster, CA 93534-2310
Phone (661) 942-2391

Other practice location 1

45104 10th St W
Lancaster, CA 93534-2310
Phone (661) 942-2391

Other practice location 2

37926 47th St E
Palmdale, CA 93552-3272
Phone (661) 942-2391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241010001002 CA Practitioner - Clinical Social Worker 3274065602 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW90759CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
JWCH Institute Inc CurrentSince Aug 3, 2024 Accepting new patients
JWCH Institute, Inc. CurrentSince Aug 3, 2024 Accepting new patients
JWCH Institute Inc Current Accepting new patients

Locations

5650 Jillson St
Commerce, CA 90040
Phone (213) 484-1186

45104 10th St W
Lancaster, CA 93534
Phone (661) 941-9543

954 N Vermont Ave
Los Angeles, CA 90029
Phone (323) 454-4850

12360 Firestone Blvd
Norwalk, CA 90650
Phone (562) 281-0305

2151 E Palmdale Blvd
Palmdale, CA 93550
Phone (661) 273-3222

37926 47th St E
Palmdale, CA 93552
Phone 32320145163204

Interoperability endpoints

  • Direct secure messaging: sandy.penalcsw.p1@direct.jwch.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1902455827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45104 10TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342310",
            "telephone_number": "661-942-2391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 E PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504037",
            "telephone_number": "661-942-2391"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45104 10th St W",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "CA",
            "postal_code": "935342310",
            "country_code": "US",
            "telephone_number": "661-942-2391",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "37926 47th St E",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935523272",
            "country_code": "US",
            "telephone_number": "661-942-2391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENA",
        "first_name": "SANDY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW90759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.