Emma Medina, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

109813 Issued in CA

Practice address

828 W Ventura St Ste 240
Fillmore, CA 93015-1882

Phone

(805) 524-8660

NPI assigned

Aug 1, 2017

Last updated

Nov 22, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Emma Ruiz Mercado Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• County of Ventura

  dba Ventura County Medical Center

  • General Acute Care Hospital
  • Ventura, CA
  • NPI 1629167457
  Medicare reassignment NPD
• County of Ventura

  dba VCBH - Simi Valley Youth & Family Mental Health

  • Community/Behavioral Health Agency
  • Simi Valley, CA
  • NPI 1609098243
  NPD
• County of Ventura

  • Public Health & General Preventive Medicine Physician
  • Oxnard, CA
  • NPI 1962931477
  NPD

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1952825903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 W VENTURA ST STE 240",
            "city": "FILLMORE",
            "state": "CA",
            "postal_code": "930151882",
            "telephone_number": "805-933-8660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 W VENTURA ST STE 240",
            "city": "FILLMORE",
            "state": "CA",
            "postal_code": "930151882",
            "telephone_number": "805-524-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "EMMA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-01",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "109813",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMMA",
            "last_name": "RUIZ MERCADO",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Araceli Magana
• Anne H Marcelino, LICENSE PHLEBOTOMIST
• Jose L Martin
• Cynthia Maynard
• Breanna McLain, ATC
• Yolanda Mejia
• Raymond M Menchaca, M.D.
• Jose Manuel Mendoza, NURSE PRACTITIONER
• Blanca M Mercado Hernandez, PPS
• Mikael Hakansson, M.D. Corp.

• Clinical Social Worker in Fillmore, CA
• Providers in Fillmore, 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 Nov 22, 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.