Active NPI
Ayumi Omoto
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1992106850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 1730 W Olympic Blvd
Floor 3a, Suite #100
Los Angeles, CA 90015-1019 - Phone
- (213) 553-1884
- Fax
- (213) 236-9662
- NPI assigned
- Sep 10, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
1730 W Olympic Blvd
Floor 3a, Suite #100
Los Angeles, CA 90015-1019
Mailing address
1730 W Olympic Blvd
Floor 3a, Suite #100
Los Angeles, CA 90015-1019
Phone (213) 553-1884
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
| License | State | Type | Specialty |
|---|---|---|---|
| 20112 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410307200000",
"number": "1992106850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1730 W OLYMPIC BLVD",
"address_2": "FLOOR 3A, SUITE #100",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900151019",
"telephone_number": "213-553-1884",
"fax_number": "213-236-9662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1730 W OLYMPIC BLVD",
"address_2": "FLOOR 3A, SUITE #100",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900151019",
"telephone_number": "213-553-1884",
"fax_number": "213-236-9662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OMOTO",
"first_name": "AYUMI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-10",
"last_updated": "2014-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"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 Sep 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.