Active NPI
Elizabeth Kristine Brenenstall, LCSW
- Clinical Social Worker
- Ontario, CA
National Provider Identifier
1235339078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS23186
- Practice address
- 2990 Inland Empire Blvd
Suite 101
Ontario, CA 91764-4899 - Phone
- (909) 980-3427
- NPI assigned
- Jul 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS23186 | CA | Primary |
Addresses
Primary practice location
2990 Inland Empire Blvd
Suite 101
Ontario, CA 91764-4899
Mailing address
1556 S Sultana Ave
Ontario, CA 91761-4238
Phone (909) 184-6923
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
| License | State | Type | Specialty |
|---|---|---|---|
| LCS23186 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Clinics | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Ontario, CA
- NPI 1902273923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596499200000",
"number": "1235339078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1556 S SULTANA AVE",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917614238",
"telephone_number": "909-184-6923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2990 INLAND EMPIRE BLVD",
"address_2": "SUITE 101",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917644899",
"telephone_number": "909-980-3427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENENSTALL",
"first_name": "ELIZABETH",
"middle_name": "KRISTINE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-19",
"last_updated": "2020-08-04",
"certification_date": "2020-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS23186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.