Active NPI
Keli-Rae Weisenberger, LCSW
- Clinical Social Worker
- Moreno Valley, CA
National Provider Identifier
1104570803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW102064
- Practice address
- 24655 Moonlight Dr
Moreno Valley, CA 92551-7299 - Phone
- (951) 520-6168
- NPI assigned
- Feb 10, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW102064 | CA | Primary |
Addresses
Primary practice location
24655 Moonlight Dr
Moreno Valley, CA 92551-7299
Mailing address
24655 Moonlight Dr
Moreno Valley, CA 92551-7299
Phone (951) 520-6168
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW102064 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644451200000",
"number": "1104570803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24655 MOONLIGHT DR",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925517299",
"telephone_number": "951-520-6168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24655 MOONLIGHT DR",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925517299",
"telephone_number": "951-520-6168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISENBERGER",
"first_name": "KELI-RAE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-10",
"last_updated": "2022-02-10",
"certification_date": "2022-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW102064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moreno Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.