Active NPI
Tim Ross
- Clinical Social Worker
- Morro Bay, CA
National Provider Identifier
1003260845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS20247
- Practice address
- 710 Bella Vista Dr
Morro Bay, CA 93442-2417 - Phone
- (805) 458-5601
- NPI assigned
- Apr 18, 2016
- Sex
- Male
- 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 | LCS20247 | CA | Primary |
Addresses
Primary practice location
710 Bella Vista Dr
Morro Bay, CA 93442-2417
Mailing address
710 Bella Vista Dr
Morro Bay, CA 93442-2417
Phone (805) 458-5601
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS20247 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460937600000",
"number": "1003260845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 BELLA VISTA DR",
"city": "MORRO BAY",
"state": "CA",
"postal_code": "934422417",
"telephone_number": "805-458-5601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 BELLA VISTA DR",
"city": "MORRO BAY",
"state": "CA",
"postal_code": "934422417",
"telephone_number": "805-458-5601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "TIM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-18",
"last_updated": "2016-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS20247",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morro Bay, CA
- Revive Then Thrive Marriage and Family Therapy, Inc.
- Candice Allysha Rodriguez, RDN
- Crystal Louise Rose, LCSW
- Ross J. Dover, PT
- Kristi Ann Ross, LCSW,CADC
- Ryan Garcia DDS PC
- Jason Sajulan, PA-C
- Lisa Anne Kolberg Salopek, LCSW
- San Luis Physical Therapy & Orthopedic Rehabilitation Inc
- Annie-Claude Sanchis, NP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.