Jeralyn E Bolanos, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW118720 Issued in CA

Practice address

11050 Artesia Blvd Ste F
Cerritos, CA 90703-2542

Phone

(562) 860-8838

Fax

(562) 860-0248

NPI assigned

Jul 31, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1922586072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 ARTESIA BLVD STE F",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032542",
            "telephone_number": "562-860-8838",
            "fax_number": "562-860-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 ARTESIA BLVD STE F",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032542",
            "telephone_number": "562-860-8838",
            "fax_number": "562-860-0248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 S Beaudry Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900171466",
            "country_code": "US",
            "telephone_number": "213-241-3841",
            "fax_number": "213-241-3305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLANOS",
        "first_name": "JERALYN",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "97310",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ACSW97310",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ACSW97310",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW118720",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean Blanco
• Elmo Blen
• Dawn Bloore, DDS
• Jesmine Boghawala, D.D.S, M.P.A, B.D.S
• Sharon Mallari Bolado, O.D.
• Laura Boldin
• Marvin Bonilla
• Allison May Locsin Bonpin, RPH
• Palarb Boonmee, DDS
• Daniely Borges de Andrade

• Clinical Social Worker in Cerritos, CA
• Providers in Cerritos, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.