Active NPI
Anthony Altenbach, LCSW
- Clinical Social Worker
- San Bernardino, CA
National Provider Identifier
1124224175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS 6975
- Practice address
- 325 W Hospitality LN
Suite312
San Bernardino, CA 92408-3243 - Phone
- (909) 386-5500
- Fax
- (909) 386-5520
- NPI assigned
- Jun 26, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS 6975 | CA | Primary |
Addresses
Primary practice location
325 W Hospitality LN
Suite312
San Bernardino, CA 92408-3243
Mailing address
325 W Hospitality LN
Suite312
San Bernardino, CA 92408-3243
Phone (909) 386-5500
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 |
|---|---|---|---|
| LCS 6975 | CA | MD | Clinical Social Worker |
| 6975 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124224175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 W HOSPITALITY LN",
"address_2": "SUITE312",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924083243",
"telephone_number": "909-386-5500",
"fax_number": "909-386-5520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 W HOSPITALITY LN",
"address_2": "SUITE312",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924083243",
"telephone_number": "909-386-5500",
"fax_number": "909-386-5520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALTENBACH",
"first_name": "ANTHONY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS 6975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, 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.