Individual provider Active NPI

Carlos Galvan Morales

  • Clinical Social Worker
  • Ontario, CA
National Provider Identifier
1023205390
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW29198 Issued in CA
Practice address
980 W 6TH St Ste 124
Ontario, CA 91762-1208
Phone
(909) 648-8075
NPI assigned
Oct 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW29198 CA Primary

Addresses

Primary practice location

980 W 6TH St Ste 124
Ontario, CA 91762-1208

Mailing address

980 W 6TH St Ste 124
Ontario, CA 91762-1208
Phone (909) 648-8075

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170713002926 CA Practitioner - Clinical Social Worker 9830469428 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW29198CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca Clinical CurrentSince Apr 1, 2025 Accepting new patients
Cyti Health PC CurrentSince Sep 15, 2024 Accepting new patients

Locations

11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317

3111 Camino del Rio N
Ste 460
San Diego, CA 92108

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1023205390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 W 6TH ST STE 124",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917621208",
            "telephone_number": "909-648-8075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 W 6TH ST STE 124",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917621208",
            "telephone_number": "909-648-8075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "CARLOS",
        "middle_name": "GALVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-01",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW29198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

Verify at the official NPI Registry.