Individual provider Active NPI

Joan Mendoza, LCSW

  • Clinical Social Worker
  • Covina, CA
National Provider Identifier
1912216292
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
80435 Issued in CA
Practice address
1338 Center Court Dr Ste 107
Covina, CA 91724
Phone
(323) 533-3837
NPI assigned
Oct 4, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 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 80435 CA Primary

Addresses

Primary practice location

1338 Center Court Dr Ste 107
Covina, CA 91724

Mailing address

1338 Center Court Dr Ste 107
Covina, CA 91724-3681
Phone (323) 533-3837

Other practice location 1

5970 S Central Ave
Los Angeles, CA 90001-1150
Phone (323) 234-3280

Other practice location 2

1338 Center Court Dr Ste 107
Covina, CA 91724
Phone (323) 533-3837

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
I20190622000244 CA Practitioner - Clinical Social Worker 9931433182 Practice locations: Montclair, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rooted Empowerment Collective Clinical CurrentSince Feb 6, 2022 Accepting new patients

Locations

1338 Center Court Dr
Ste 107
Covina, CA 91724
Phone (323) 533-3837

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1912216292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1338 CENTER COURT DR STE 107",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917243681",
            "telephone_number": "323-533-3837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1338 CENTER COURT DR STE 107",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "91724",
            "telephone_number": "323-533-3837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5970 S Central Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900011150",
            "country_code": "US",
            "telephone_number": "323-234-3280",
            "fax_number": "323-234-3493",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1338 Center Court Dr Ste 107",
            "address_purpose": "LOCATION",
            "city": "Covina",
            "state": "CA",
            "postal_code": "91724",
            "country_code": "US",
            "telephone_number": "323-533-3837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "JOAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-04",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "80435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.