Active NPI
Debra Lynn McCormick, LCSW
- Social Worker
- San Jacinto, CA
National Provider Identifier
1104902527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LCS22902
- Practice address
- 950 Ramona Blvd Ste 2
San Jacinto, CA 92583 - Phone
- (951) 487-2674
- NPI assigned
- Oct 27, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | LCS22902 | CA | Primary |
Addresses
Primary practice location
950 Ramona Blvd Ste 2
San Jacinto, CA 92583
Mailing address
26910 Placentia Ave
Perris, CA 92571
Phone (951) 443-4493
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS22902 | CA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Riverside | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- San Jacinto, CA
- NPI 1659738813
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104902527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26910 PLACENTIA AVE",
"city": "PERRIS",
"state": "CA",
"postal_code": "92571",
"telephone_number": "951-443-4493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 RAMONA BLVD STE 2",
"city": "SAN JACINTO",
"state": "CA",
"postal_code": "92583",
"telephone_number": "951-487-2674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMICK",
"first_name": "DEBRA",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "LCS22902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jacinto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.