Individual provider Active NPI

Maria Guadalupe Chavez-Brown

  • Clinical Social Worker
  • Indio, CA
National Provider Identifier
1073873626
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS28256 Issued in CA
Practice address
83445 Wagon Rd
Indio, CA 92203-2836
Phone
(760) 574-3514
NPI assigned
May 16, 2012
Last updated
Aug 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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 LCS28256 CA Primary

Addresses

Primary practice location

83445 Wagon Rd
Indio, CA 92203-2836

Mailing address

44100 Jefferson St # D403-255
Indio, CA 92201-9014
Phone (760) 574-3514

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
I20120531000182 CA Practitioner - Clinical Social Worker 7517120538 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS28256CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicas de Salud del Pueblo, Inc CurrentSince Feb 16, 2019 Accepting new patients
Inland Psychiatric Medical Group, Inc. Clinical CurrentSince Aug 17, 2020 Accepting new patients
Inland Psychiatric Medical Group, Inc. CurrentSince Aug 17, 2020 Accepting new patients
Clinicas de Salud del Pueblo, Inc Current Accepting new patients
Inland Psychiatric Medical Group, Inc. Clinical Current Accepting new patients
Clinicas de Salud del Pueblo Inc. CurrentSince Feb 16, 2019 Accepting new patients
Palm Springs Unified School District Past Accepting new patients

Locations

321 W Hobsonway
Ste C
Blythe, CA 92225
Phone (760) 922-4981

1166 K St
Brawley, CA 92227
Phone (760) 344-3583

50249 Harrison St
Ste K
Coachella, CA 92236
Phone (760) 393-0555

23110 Atlantic Cir
Ste F
Moreno Valley, CA 92553
Phone (951) 243-6455

73700 Dinah Shore Dr
Ste 106
Palm Desert, CA 92211
Phone (760) 832-6352

8710 Monroe Ct
Ste 150
Rancho Cucamonga, CA 91730
Phone (909) 941-4870

1809 W Redlands Blvd
Redlands, CA 92373
Phone (909) 307-1320

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1073873626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44100 JEFFERSON ST # D403-255",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922019014",
            "telephone_number": "760-574-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83445 WAGON RD",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922032836",
            "telephone_number": "760-574-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ-BROWN",
        "first_name": "MARIA",
        "middle_name": "GUADALUPE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-16",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS28256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

Verify at the official NPI Registry.