Individual provider Active NPI

Miranda Renee Leon, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1235769100
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW124658 Issued in CA
Practice address
402 W Broadway Ste 400
San Diego, CA 92101-3554
Phone
(866) 478-3978
NPI assigned
Jan 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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 LCSW124658 CA Primary

Addresses

Primary practice location

402 W Broadway Ste 400
San Diego, CA 92101-3554

Mailing address

2283 Kyla CT
San Bernardino, CA 92410-1305
Phone (951) 275-4944

Other practice location 1

2283 Kyla Ct
San Bernardino, CA 92410-1305
Phone (951) 275-4944

Other names 1

  • Miranda Renee Barnes Former name

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
I20240912000090 CA Practitioner - Clinical Social Worker 3173063542 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ACSW102338CAMDClinical Social Worker
124658CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cyti Health PC CurrentSince Aug 8, 2024 Accepting new patients

Locations

11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317

3111 Camino del Rio N
Ste 460
San Diego, CA 92108

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

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.

NPI Registry JSON

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1235769100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2283 KYLA CT",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924101305",
            "telephone_number": "951-275-4944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W BROADWAY STE 400",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013554",
            "telephone_number": "866-478-3978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2283 Kyla Ct",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924101305",
            "country_code": "US",
            "telephone_number": "951-275-4944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEON",
        "first_name": "MIRANDA",
        "middle_name": "RENEE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-20",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW124658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRANDA",
            "last_name": "BARNES",
            "middle_name": "RENEE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.