Individual provider Active NPI

Bertha Alicia Ramos

  • Clinical Social Worker
  • San Pedro, CA
National Provider Identifier
1215052832
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW60542 Issued in CA
Practice address
624 W 9TH St Ste 103
San Pedro, CA 90731-3158
Phone
(310) 938-4575
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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 LCSW60542 CA Primary

Addresses

Primary practice location

624 W 9TH St Ste 103
San Pedro, CA 90731-3158

Mailing address

811 W 232ND St Unit C
Torrance, CA 90502-2534
Phone (626) 484-8909

Other practice location 1

100 Falls Canyon Rd
Avalon, CA 90704-2990
Phone (310) 510-0700

Other practice location 2

1360 N Main St
Bishop, CA 93514-3013
Phone (760) 872-2590

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
I20170826000434 CA Practitioner - Clinical Social Worker 3779853791 Reassigns benefits to 3 organizations
Practice locations: San Pedro, CA; Torrance, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Step Family Counseling IncGroup PAC ID 9234371436, 2 clinicians

Practice addresses (Care Compare)

624 W 9TH St
Suite 103
San Pedro, CA 90731-3158
Phone (310) 938-4575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW60542CAMDClinical Social Worker
60542CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Avalon Medical Development Corporation CurrentSince Dec 4, 2017 Accepting new patients
First Step Family Counseling, Inc. CurrentSince Feb 21, 2019 Accepting new patients

Locations

100 Falls Canyon Rd
Avalon, CA 90704
Phone (310) 510-0700

624 W 9th St
Ste 103
San Pedro, CA 90731
Phone (310) 518-4279

Interoperability endpoints

  • Direct secure messaging: bertha.ramos.1@14021.direct.athenahealth.com

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1215052832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 W 232ND ST UNIT C",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022534",
            "telephone_number": "626-484-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 W 9TH ST STE 103",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313158",
            "telephone_number": "310-938-4575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Falls Canyon Rd",
            "address_purpose": "LOCATION",
            "city": "Avalon",
            "state": "CA",
            "postal_code": "907042990",
            "country_code": "US",
            "telephone_number": "310-510-0700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1360 N Main St",
            "address_purpose": "LOCATION",
            "city": "Bishop",
            "state": "CA",
            "postal_code": "935143013",
            "country_code": "US",
            "telephone_number": "760-872-2590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAMOS",
        "first_name": "BERTHA",
        "middle_name": "ALICIA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW60542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

Verify at the official NPI Registry.