Individual provider Active NPI

Erick Steve Nunez

  • Clinical Social Worker
  • San Bernardino, CA
National Provider Identifier
1174883946
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
107448 Issued in CA
Practice address
772 W 19TH St
San Bernardino, CA 92405-4239
Phone
(213) 375-5028
NPI assigned
May 25, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW88766 CA
Rehabilitation Practitioner 225400000X
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 107448 CA Primary

Addresses

Primary practice location

772 W 19TH St
San Bernardino, CA 92405-4239

Mailing address

772 W 19TH St
San Bernardino, CA 92405-4239
Phone (213) 375-5028

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
I20250805002539 CA Practitioner - Clinical Social Worker 8527576081 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW88766CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Coast Psych Medical Associates PC Single Specialty CurrentSince May 22, 2025 Accepting new patients

Locations

903 E Devonshire Ave
Ste E
Hemet, CA 92543
Phone (951) 322-4532

903 E Devonshire Ave
Ste F
Hemet, CA 92543
Phone (951) 929-1611

33175 Temecula Pkwy
Ste A
Temecula, CA 92592

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.

NPI Registry JSON

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1174883946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "772 W 19TH ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924054239",
            "telephone_number": "213-375-5028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "772 W 19TH ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924054239",
            "telephone_number": "213-375-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNEZ",
        "first_name": "ERICK",
        "middle_name": "STEVE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-25",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW88766",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "107448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.