Active NPI
Ricardo Pena
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1972764306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ASW29832
- Practice address
- 1200 Wilshire Blvd
Los Angeles, CA 90017-1908 - Phone
- (213) 481-7464
- Fax
- (213) 481-7147
- NPI assigned
- Jun 18, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ASW29832 | CA | Primary |
| Counselor | 101Y00000X |
Addresses
Primary practice location
1200 Wilshire Blvd
Los Angeles, CA 90017-1908
Mailing address
1200 Wilshire Blvd
Los Angeles, CA 90017-1908
Phone (213) 481-7464
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 |
|---|---|---|---|
| ASW29832 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459209600000",
"number": "1972764306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 WILSHIRE BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900171908",
"telephone_number": "213-481-7464",
"fax_number": "213-481-7147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 WILSHIRE BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900171908",
"telephone_number": "213-481-7464",
"fax_number": "213-481-7147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENA",
"first_name": "RICARDO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-18",
"last_updated": "2016-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW29832",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
}
],
"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 Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.