Individual provider Active NPI

Maritza Pelayo

  • Clinical Social Worker
  • Upland, CA
National Provider Identifier
1083167589
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
102116 Issued in CA
Practice address
954 W Foothill Blvd Ste a
Upland, CA 91786-3782
Phone
(909) 946-4222
Fax
(909) 946-8243
NPI assigned
Aug 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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 102116 CA Primary

Addresses

Primary practice location

954 W Foothill Blvd Ste a
Upland, CA 91786-3782

Mailing address

954 W Foothill Blvd Ste a
Upland, CA 91786-3782
Phone (909) 946-4222

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
I20220613002113 CA Practitioner - Clinical Social Worker 5092193581 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
102116CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mission City Community Network, Inc. CurrentSince Feb 21, 2024 Accepting new patients
Mission City Community Network, Inc. CurrentSince Feb 21, 2024 Accepting new patients
Foothills Psychological Services, Inc. CurrentSince Dec 11, 2023 Accepting new patients
Mission City Community Network, Inc. Current Accepting new patients

Locations

5050 San Bernardino St
Montclair, CA 91763
Phone (909) 281-5800

8363 Reseda Blvd
Ste 11
Northridge, CA 91324
Phone 8188953100602

1550 N Park Ave
Pomona, CA 91768
Phone (909) 623-0791

15206 Parthenia St
Sepulveda, CA 91343

954 W Foothill Blvd
Ste A
Upland, CA 91786
Phone (909) 946-4222

600 N Euclid Ave
Ste 204
Upland, CA 91786
Phone (909) 379-1513

15201 Eleventh St
Ste 300
Victorville, CA 92395
Phone (760) 245-1640

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1083167589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 W FOOTHILL BLVD STE A",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863782",
            "telephone_number": "909-946-4222",
            "fax_number": "909-946-8243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 W FOOTHILL BLVD STE A",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863782",
            "telephone_number": "909-946-4222",
            "fax_number": "909-946-8243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELAYO",
        "first_name": "MARITZA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-01",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "102116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.