Individual provider Active NPI

Mayra Covarrubias, MSW, LCSW, PPSC

  • Clinical Social Worker
  • Pomona, CA
National Provider Identifier
1174076871
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
106486 Issued in CA
Practice address
21 Rancho Camino Dr Ste 102
Pomona, CA 91766-7020
Phone
(888) 588-8995
NPI assigned
Jul 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 106486 CA Primary

Addresses

Primary practice location

21 Rancho Camino Dr Ste 102
Pomona, CA 91766-7020

Mailing address

PO Box 1142
West Covina, CA 91793-1142

Other practice location 1

1000 G St Ste 125
Sacramento, CA 95814-0894
Phone (888) 588-8995

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
I20220615000598 CA Practitioner - Clinical Social Worker 1355720756 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106486CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Cyti Health PC CurrentSince Jan 14, 2026 Accepting new patients
Blue Oak Counseling Services, Inc. Past Accepting new patients

Locations

11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317

3111 Camino del Rio N
Ste 460
San Diego, CA 92108

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

Organizations & group practices 2

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": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1174076871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1142",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917931142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 RANCHO CAMINO DR STE 102",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917667020",
            "telephone_number": "888-588-8995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 G St Ste 125",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958140894",
            "country_code": "US",
            "telephone_number": "888-588-8995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COVARRUBIAS",
        "first_name": "MAYRA",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW, PPSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-28",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "106486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.