Wombat Mental Health Services a LCSW Professional Corporation

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

WOMBAT MENTAL HEALTH SERVICES A LCSW PROFESSIONAL CORPORATION

Practice address

9431 Haven Avenue
Suite 100
Rancho Cucamonga, CA 91730-5878

Phone

(840) 999-1767

NPI assigned

Sep 15, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Erik James Escareno, DSW, LSCWNPI 1144476474

Title

Chief Executive Officer

Phone

(840) 999-1767

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Erik James Escareno, DSW, LCSW

  • Clinical Social Worker
  • Rancho Cucamonga, CA
  • NPI 1144476474
  NPD Authorized official

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664755200000",
    "number": "1285356337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9431 HAVEN AVENUE",
            "address_2": "SUITE 100",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305878",
            "telephone_number": "840-999-1767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9431 HAVEN AVENUE",
            "address_2": "SUITE 100",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305878",
            "telephone_number": "840-999-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMBAT MENTAL HEALTH SERVICES A LCSW PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A",
        "authorized_official_last_name": "ESCARENO",
        "authorized_official_first_name": "ERIK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "840-999-1767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DSW, LSCW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Alan Wise, AU.D.
• Kayla Wojciechowski
• Ronette Letania Wolfe
• Victoria Wolfe
• Joshua Womack
• Women'S Medical Group of Upland Inc.
• Wonderful Life Dental Group
• Alex Wong
• Chris Wong
• Corinne Francine Wong, OD

• Clinical Social Worker in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, 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 Oct 3, 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.