Active NPI
Thomas Kenneth Ebersten, LCSW
- Clinical Social Worker
- Cathedral City, CA
National Provider Identifier
1366543704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 22337
- Practice address
- 68625 Perez Rd
Cathedral City, CA 92234-7250 - Phone
- (760) 863-7874
- NPI assigned
- Sep 26, 2006
- Last updated
- Sep 20, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 22337 | CA | Primary |
Addresses
Primary practice location
68625 Perez Rd
Cathedral City, CA 92234-7250
Mailing address
16800 Lakeside CT
Desert Hot Springs, CA 98241
Phone (760) 288-2711
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316476800000",
"number": "1366543704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16800 LAKESIDE CT",
"city": "DESERT HOT SPRINGS",
"state": "CA",
"postal_code": "98241",
"telephone_number": "760-288-2711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "68625 PEREZ RD",
"city": "CATHEDRAL CITY",
"state": "CA",
"postal_code": "922347250",
"telephone_number": "760-863-7874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBERSTEN",
"first_name": "THOMAS",
"middle_name": "KENNETH",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2011-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "22337",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cathedral City, CA
- Dr. Robert Ohrling, Inc.
- Dual Diagnosis Treatment Center, Inc. (Sovereign Health of California)
- Diane E. Ducatte
- Joseph Wayne Dunn, PH.D.
- Jasmine Viviana Duran, PPS
- Elliott Edes, MD
- Eisenhower Medical Center (Eisenhower)
- Eisenhower Medical Center (Eisenhower Health)
- Eisenhower Medical Center (Eisenhower Health)
- El Desert Ride
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.