Individual provider Active NPI

Daisy Rivera, LCSW

  • Clinical Social Worker
  • Fullerton, CA
National Provider Identifier
1063933489
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
86092 Issued in CA
Practice address
1835 Sunny Crest Dr
Fullerton, CA 92835-3616
Phone
(714) 446-5101
NPI assigned
Jul 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 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 86092 CA Primary

Addresses

Primary practice location

1835 Sunny Crest Dr
Fullerton, CA 92835-3616

Mailing address

1835 Sunny Crest Dr
Fullerton, CA 92835-3616
Phone (714) 446-5101

Other names 1

  • Daisy Mejia Former name

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
I20231006002845 CA Practitioner - Clinical Social Worker 5991150161 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86092CAMDMarriage & Family Therapist
76093CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Nov 26, 2025 Accepting new patients
Providence Medical Foundation Current Accepting new patients

Locations

1835 Sunny Crest Dr
Fullerton, CA 92835
Phone (714) 446-5101

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1063933489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 SUNNY CREST DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353616",
            "telephone_number": "714-446-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 SUNNY CREST DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353616",
            "telephone_number": "714-446-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "DAISY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-06",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "86092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAISY",
            "last_name": "MEJIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.