Individual provider Active NPI

Eric C Murillo Angelo, LCSW

  • Clinical Social Worker
  • Pomona, CA
National Provider Identifier
1235261876
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
27485 Issued in CA
Practice address
185 E Jefferson Ave
Pomona, CA 91767-3815
Phone
(909) 629-1050
NPI assigned
Mar 9, 2007
Last updated
Jul 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

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 ASW18478 CA
Clinical Social Worker 1041C0700X 27485 CA Primary

Addresses

Primary practice location

185 E Jefferson Ave
Pomona, CA 91767-3815

Mailing address

185 E Jefferson Ave
Pomona, CA 91767-3815

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
27485CAMDClinical Social Worker
ASW18478CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
High Desert Psychological Services Clinical CurrentSince Feb 25, 2022 Accepting new patients

Locations

15497 W Sand St
Victorville, CA 92392
Phone (442) 327-9311

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1235261876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 E JEFFERSON AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 E JEFFERSON AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673815",
            "telephone_number": "909-629-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURILLO ANGELO",
        "first_name": "ERIC",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW18478",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "27485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; 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.