Individual provider Active NPI

Mario Espitia, DSW, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1962606145
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
68366 Issued in CA
Practice address
1441 Eastlake Ave
Los Angeles, CA 90089-1019
Phone
(323) 865-3782
Fax
(323) 865-9214
NPI assigned
Jun 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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 68366 CA Primary

Addresses

Primary practice location

1441 Eastlake Ave
Los Angeles, CA 90089-1019

Mailing address

1441 Eastlake Ave
Los Angeles, CA 90089-1019
Phone (323) 865-3782

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
68366CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1962606145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 EASTLAKE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900891019",
            "telephone_number": "323-865-3782",
            "fax_number": "323-865-9214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 EASTLAKE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900891019",
            "telephone_number": "323-865-3782",
            "fax_number": "323-865-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPITIA",
        "first_name": "MARIO",
        "name_prefix": "Dr.",
        "credential": "DSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "68366",
            "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 Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.