Individual provider Active NPI

Rebecca Sue Hyatt, LCSW, CEAP

  • Clinical Social Worker
  • Palm Springs, CA
National Provider Identifier
1285666396
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS9075 Issued in CA
Practice address
1111 E. Tahquitz Canyon Way
Suite 121
Palm Springs, CA 92262-0102
Phone
(760) 861-2591
Fax
(760) 770-1083
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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 LCS9075 CA Primary

Addresses

Primary practice location

1111 E. Tahquitz Canyon Way
Suite 121
Palm Springs, CA 92262-0102

Mailing address

1111 E. Tahquitz Canyon Way
Suite 121
Palm Springs, CA 92262-0102
Phone (760) 318-6570

Other identifiers 2

IdentifierTypeStateIssuer
050513OtherCAMANAGED HEALTH NETWORK
072767000OtherCAMAGELLAN PROVIDER #

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
I20100909000382 CA Practitioner - Clinical Social Worker 9335264795 Practice locations: La Palma, CA; Palm Springs, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS9075CAMDClinical Social Worker
9075CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
The Happy Homo PastSince May 1, 2023 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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1285666396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E. TAHQUITZ CANYON WAY",
            "address_2": "SUITE 121",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922620102",
            "telephone_number": "760-318-6570",
            "fax_number": "760-318-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E. TAHQUITZ CANYON WAY",
            "address_2": "SUITE 121",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922620102",
            "telephone_number": "760-861-2591",
            "fax_number": "760-770-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYATT",
        "first_name": "REBECCA",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "LCSW, CEAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS9075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "050513",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN PROVIDER #",
            "identifier": "072767000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

Verify at the official NPI Registry.