Active NPI
Pak22 LLC
- Clinical Social Worker
- Walnut Park, CA
National Provider Identifier
1962297689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- PAK22 LLC
- Practice address
- 3012 California St
Walnut Park, CA 90255-5912 - Phone
- (323) 864-7220
- NPI assigned
- Apr 12, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alejandro Zendejas III
- Title
- Owner
- Phone
- (323) 864-7220
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
3012 California St
Walnut Park, CA 90255-5912
Mailing address
3012 California St
Walnut Park, CA 90255-5912
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250520004441 | CA | Part B Supplier - Clinic/Group Practice | 1254859481 |
Receives reassigned benefits from 1 practitioner Practice locations: Walnut Park, CA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744416000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1744416000000",
"number": "1962297689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3012 CALIFORNIA ST",
"city": "WALNUT PARK",
"state": "CA",
"postal_code": "902555912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3012 CALIFORNIA ST",
"city": "WALNUT PARK",
"state": "CA",
"postal_code": "902555912",
"telephone_number": "323-864-7220"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PAK22 LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-04-12",
"last_updated": "2025-04-12",
"certification_date": "2025-04-12",
"status": "A",
"authorized_official_last_name": "ZENDEJAS",
"authorized_official_first_name": "ALEJANDRO",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "323-864-7220",
"authorized_official_name_suffix": "III"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.