Individual provider Active NPI

Jose Luis Burgos, ASW

  • Clinical Social Worker
  • Arcadia, CA
National Provider Identifier
1982938189
Registry record updated Jun 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
64083 Issued in CA
Practice address
330 E Live Oak Ave
Arcadia, CA 91006
Phone
(626) 254-1400
NPI assigned
Sep 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2018

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 64083 CA Primary

Addresses

Primary practice location

330 E Live Oak Ave
Arcadia, CA 91006

Mailing address

330 E Live Oak Ave
Arcadia, CA 91006-5617
Phone (626) 254-1400

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180706000078 CA Practitioner - Clinical Social Worker 5799031738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Los Angeles County Department of Mental HealthGroup PAC ID 7416869896, 294 clinicians

Practice addresses (Care Compare)

330 E Live Oak Ave
Arcadia MHS
Arcadia, CA 91006-5617
Phone (626) 821-5858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64083CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince May 26, 2018 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince May 26, 2018 Accepting new patients

Locations

330 E Live Oak Ave
Arcadia, CA 91006
Phone (626) 254-1400

349A E Avenue K6
Lancaster, CA 93535
Phone (661) 723-4260

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1982938189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E LIVE OAK AVE",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910065617",
            "telephone_number": "626-254-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E LIVE OAK AVE",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "91006",
            "telephone_number": "626-254-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOS",
        "first_name": "JOSE",
        "middle_name": "LUIS",
        "name_prefix": "Mr.",
        "credential": "ASW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-22",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "64083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.