Active NPI
Megan Holmberg
- Clinical Social Worker
- Riverside, CA
National Provider Identifier
1043799430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 123503
- Practice address
- 3125 Myers St
Riverside, CA 92503-5527 - Phone
- (951) 275-6000
- NPI assigned
- Aug 7, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | CA | ||
| Clinical Social Worker | 1041C0700X | 123503 | CA | Primary |
| Mental Health Counselor | 101YM0800X |
Addresses
Primary practice location
3125 Myers St
Riverside, CA 92503-5527
Mailing address
1330 W Ramsey St
Banning, CA 92220-4477
Phone (951) 849-7142
Other practice location 1
9916 Central Ave
Montclair, CA 91763-3201
Phone (909) 450-2502
Other practice location 2
1330 W Ramsey St
Banning, CA 92220-4477
Phone (951) 849-7142
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 |
|---|---|---|---|
| 123503 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733097600000",
"number": "1043799430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1330 W RAMSEY ST",
"city": "BANNING",
"state": "CA",
"postal_code": "922204477",
"telephone_number": "951-849-7142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3125 MYERS ST",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925035527",
"telephone_number": "951-275-6000"
}
],
"practiceLocations": [
{
"address_1": "9916 Central Ave",
"address_purpose": "LOCATION",
"city": "Montclair",
"state": "CA",
"postal_code": "917633201",
"country_code": "US",
"telephone_number": "909-450-2502",
"fax_number": "909-450-2637",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1330 W Ramsey St",
"address_purpose": "LOCATION",
"city": "Banning",
"state": "CA",
"postal_code": "922204477",
"country_code": "US",
"telephone_number": "951-849-7142",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLMBERG",
"first_name": "MEGAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-07",
"last_updated": "2024-12-02",
"certification_date": "2024-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "123503",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.