Active NPI
Eric C Murillo Angelo, LCSW
- Clinical Social Worker
- Pomona, CA
National Provider Identifier
1235261876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 27485
- Practice address
- 185 E Jefferson Ave
Pomona, CA 91767-3815 - Phone
- (909) 629-1050
- NPI assigned
- Mar 9, 2007
- Last updated
- Jul 11, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 27485 | CA | MD | Clinical Social Worker |
| ASW18478 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| High Desert Psychological Services | Clinical | Current | 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.