Individual provider Active NPI

Alma Rosa Vazquez, LCSW

  • Clinical Social Worker
  • San Bernardino, CA
National Provider Identifier
1275167926
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW94179 Issued in CA
Practice address
250 S G St
San Bernardino, CA 92410-3320
Phone
(909) 558-4800
NPI assigned
Mar 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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 LCSW94179 CA Primary

Addresses

Primary practice location

250 S G St
San Bernardino, CA 92410-3320

Mailing address

250 S G St
San Bernardino, CA 92410-3320
Phone (909) 558-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW94179CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sac Health System Current Accepting new patients
Sac Health System CurrentSince Apr 1, 2020 Accepting new patients
Sac Health System CurrentSince Apr 1, 2020 Accepting new patients

Locations

250 S G St
San Bernardino, CA 92410
Phone (909) 771-2990

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

Organizations & group practices 3

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": "1583107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1275167926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S G ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103320",
            "telephone_number": "909-558-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S G ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103320",
            "telephone_number": "909-558-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "ALMA",
        "middle_name": "ROSA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-02",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW94179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.