Active NPI
Gloria Elizabeth Mucino, LCSW
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1992815153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS11681
- Practice address
- 12301 Wilshire Blvd
Suite 210
Los Angeles, CA 90025-1007 - Phone
- (310) 826-8989
- Fax
- (310) 391-1807
- NPI assigned
- Aug 30, 2006
- 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 | LCS11681 | CA | Primary |
Addresses
Primary practice location
12301 Wilshire Blvd
Suite 210
Los Angeles, CA 90025-1007
Mailing address
12301 Wilshire Blvd
Suite 210
Los Angeles, CA 90025-1007
Phone (310) 826-8989
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11681 | Other | CA | LICENSE |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160314001003 | CA | Practitioner - Clinical Social Worker | 0648222133 | Practice locations: Los Angeles, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
12301 Wilshire Blvd
Los Angeles, CA 90025-1000
Phone (310) 826-8989
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11681 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447632000000",
"number": "1992815153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12301 WILSHIRE BLVD",
"address_2": "SUITE 210",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900251007",
"telephone_number": "310-826-8989",
"fax_number": "310-391-1807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12301 WILSHIRE BLVD",
"address_2": "SUITE 210",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900251007",
"telephone_number": "310-826-8989",
"fax_number": "310-391-1807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUCINO",
"first_name": "GLORIA",
"middle_name": "ELIZABETH",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2015-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS11681",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "11681",
"state": "CA"
}
],
"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 Nov 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.