Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jeremiah C Buenrostro

Individual provider Clinical Social Worker · NPI 1073160214

Jeremiah C Buenrostro is a Clinical Social Worker in Pasadena, California. Qualified in 2017, 9 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
9
Licensed in
CA
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

393 E Walnut St
Pasadena, CA 91188-1486
Phone: (877) 457-4772
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 120503 (CA)
Mental Health Counselor Taxonomy 101YM0800X · Licence 96364 (CA)

Record details

NPI number1073160214
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 22, 2019
Last updated in NPPESMay 8, 2024
Certification dateMarch 14, 2024
Mailing address18646 Oxnard St, Tarzana, CA 91356-1411

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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