Individual provider Active NPI

Cynthia Elise Harris, LCSW

  • Clinical Social Worker
  • Rancho Cucamonga, CA
National Provider Identifier
1184908105
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 12299 Issued in CA
Practice address
10730 Church St Apt 260
Rancho Cucamonga, CA 91730-6652
Phone
(951) 276-1100
Fax
(951) 276-1105
NPI assigned
Oct 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS 12299 CA Primary

Addresses

Primary practice location

10730 Church St Apt 260
Rancho Cucamonga, CA 91730-6652

Mailing address

10730 Church St Apt 260
Rancho Cucamonga, CA 91730-6652
Phone (951) 276-1100

Other practice location 1

4510 Brockton Ave
Suite 375
Riverside, CA 92501-4051
Phone (951) 276-1100

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

LicenseStateTypeSpecialty
LCS 12299CAMDClinical Social Worker
12299CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1184908105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10730 CHURCH ST APT 260",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917306652",
            "telephone_number": "951-276-1100",
            "fax_number": "951-276-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10730 CHURCH ST APT 260",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917306652",
            "telephone_number": "951-276-1100",
            "fax_number": "951-276-1105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4510 Brockton Ave",
            "address_2": "Suite 375",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925014051",
            "country_code": "US",
            "telephone_number": "951-276-1100",
            "fax_number": "951-276-1105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CYNTHIA",
        "middle_name": "ELISE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-10",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 12299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.