Active NPI
Omotomiwa Labisi
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1962365700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 134431
- Practice address
- 3989 S Hobart Blvd
Los Angeles, CA 90062-1124 - Phone
- (323) 508-0155
- NPI assigned
- Dec 8, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 134431 | CA | Primary |
Addresses
Primary practice location
3989 S Hobart Blvd
Los Angeles, CA 90062-1124
Mailing address
2202 W Martin Luther King Jr Blvd
Los Angeles, CA 90008-2723
Phone (323) 508-0155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 134431 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Heights Charter School | Current | Accepting new patients |
Locations
2202 W Martin Luther King Jr Blvd
Los Angeles, CA 90008
Phone (323) 299-6864
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.
-
- Local Education Agency (LEA)
- Los Angeles, CA
- NPI 1891505913
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1765152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765152000000",
"number": "1962365700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2202 W MARTIN LUTHER KING JR BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900082723",
"telephone_number": "323-508-0155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3989 S HOBART BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900621124",
"telephone_number": "323-508-0155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LABISI",
"first_name": "OMOTOMIWA",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-12-08",
"last_updated": "2025-12-08",
"certification_date": "2025-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "134431",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.