MRS. DIANITZA MEDINA (LCSW) – Clinical Social Worker, NPI 1902064074

MRS. DIANITZA MEDINA (LCSW) is a healthcare provider. based in Monterey park, California. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 71617 (). The NPI Number for MRS. DIANITZA MEDINA (LCSW) is 1902064074

Main info

Female
Sole Proprietor
17 Years Of Experience
Accepts Medicare Assignment
Name
MRS. DIANITZA MEDINA (LCSW)
NPI
1902064074
Phone
(323) 526-4016
Address
1000 CORPORATE CENTER DRIVE #650
Enumeration Date
27 May 2008
Last Update Date
4 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9097088158
Graduation Year
2009 (17 years ago)
PAC ID
8426336280
Group Practice PAC ID
2769392927
Professional Enrollment ID
I20161028001321
Address ID
CA924011109SA665XXSTXX400

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness95
Years active:18State licenses:1Other names

4,987 CLINICAL SOCIAL WORKER in CA

Provider Addresses for MRS. DIANITZA MEDINA (LCSW)

  • Corporate Center Drive, Monterey Park, Los Angeles County, California, 91754-2332, United States

    MONTEREY PARK, CA 91754

    Phone: (323) 526-4016

    Type: Mailing

  • 3111 CAMINO DEL RIO N STE 400

    SAN DIEGO, CA 921085724

    Phone: (619) 528-2233

    Type: Mailing

  • East Cesar E Chavez Avenue, Boyle Heights, Los Angeles, Los Angeles County, California, 90033, United States

    LOS ANGELES, CA 900221209

    Phone: (323) 881-3799

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-10-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20161028001321IClinical Social WorkerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 91754)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2769392927View full group profile
NameSpecialtyState
Clinical PsychologistCA
Physician AssistantCA
Physician AssistantCA
Physician AssistantCA
Family PracticeCA
Family PracticeCA
Family Practice, Internal MedicineCA

Reviews

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Frequently asked questions

What is MRS. DIANITZA MEDINA (LCSW)'s NPI number?
MRS. DIANITZA MEDINA (LCSW)'s NPI is 1902064074 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to MRS. DIANITZA MEDINA (LCSW)?
You should see MRS. DIANITZA MEDINA (LCSW) as active in CMS-hosted NPPES data.
What clinical focus is listed for MRS. DIANITZA MEDINA (LCSW)?
At a glance, MRS. DIANITZA MEDINA (LCSW) is tied to Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where in California is MRS. DIANITZA MEDINA (LCSW) registered?
Use Monterey Park, California as the headline location for MRS. DIANITZA MEDINA (LCSW) here.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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