NPIMap

Organization Active NPI

Kimberly Moret Licensed Clinical Social Worker, PC

Doing business as High Desert Wellness

  • Clinical Social Worker
  • Victorville, CA
National Provider Identifier
1083296263
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
KIMBERLY MORET LICENSED CLINICAL SOCIAL WORKER, PC
Doing business as
High Desert Wellness
Practice address
14021 Amargosa Rd Ste 100
Victorville, CA 92392-6404
Phone
(760) 513-1550
Fax
(760) 513-9743
NPI assigned
Apr 27, 2021
Last updated
Apr 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Authorized official

Name
Kimberly A Moret, LCSWNPI 1609040997
Title
Ceo
Phone
(442) 294-6934

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

14021 Amargosa Rd Ste 100
Victorville, CA 92392-6404

Mailing address

14021 Amargosa Rd Ste 100
Victorville, CA 92392-6404
Phone (760) 513-1550

Other practice location 1

9681 Business Center Dr Ste C
Rancho Cucamonga, CA 91730-4579
Phone (442) 294-6934

Other names 2

  • High Desert Wellness Doing business as
  • Solution Focused Fitness Former legal business name

National Provider Directory

National Provider Directory

Locations

14021 Amargosa Rd
Ste 100
Victorville, CA 92392
Phone (760) 881-7631

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1083296263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14021 AMARGOSA RD STE 100",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923926404",
            "telephone_number": "760-513-1550",
            "fax_number": "760-513-9743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14021 AMARGOSA RD STE 100",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923926404",
            "telephone_number": "760-513-1550",
            "fax_number": "760-513-9743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9681 Business Center Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917304579",
            "country_code": "US",
            "telephone_number": "442-294-6934",
            "fax_number": "760-513-9743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KIMBERLY MORET LICENSED CLINICAL SOCIAL WORKER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "MORET",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "442-294-6934",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "High Desert Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Solution Focused Fitness",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.