Manuela Mayorga, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW88813 Issued in CA

Practice address

26001 Redlands Blvd
Redlands, CA 92373-7762

Phone

(909) 825-7084

NPI assigned

Jan 13, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1358035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1235476094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26001 REDLANDS BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923737762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26001 REDLANDS BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923737762",
            "telephone_number": "909-825-7084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYORGA",
        "first_name": "MANUELA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-13",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW88813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Maxwell, RN, BSN, IBCLC
• Lindsay Stringer Maxwell, APRN
• Adam Paul May, PA
• Cassi L Mayle, DPT
• Tobias F. Maynard, D.D.S.
• Jorge R Mazlumian, M.D.
• Allan L McCall, M.D.
• Jessica Briana McClintock, PH.D.
• Dawn Marie McCoy
• Caitlin McCulloch

• Clinical Social Worker in Redlands, CA
• Providers in Redlands, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.