Individual provider Active NPI

Rosalina Becerra

  • Clinical Social Worker
  • Victorville, CA
National Provider Identifier
1184817850
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW63899 Issued in CA
Practice address
14420 Civic Dr
Ste 6
Victorville, CA 92392-2384
Phone
(442) 284-0588
Fax
(442) 267-4365
NPI assigned
Aug 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW21089 CA
Clinical Social Worker 1041C0700X LCSW63899 CA Primary

Addresses

Primary practice location

14420 Civic Dr
Ste 6
Victorville, CA 92392-2384

Mailing address

PO Box 401724
Hesperia, CA 92340-1724
Phone (442) 284-0588

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
I20210312000488 CA Practitioner - Clinical Social Worker 6305252545 Practice locations: Victorville, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW21089CAMDMental Health Counselor
LCSW63899CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1184817850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 401724",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923401724",
            "telephone_number": "442-284-0588",
            "fax_number": "442-267-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14420 CIVIC DR",
            "address_2": "STE 6",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922384",
            "telephone_number": "442-284-0588",
            "fax_number": "442-267-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECERRA",
        "first_name": "ROSALINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-24",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW21089",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW63899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.