Individual provider Active NPI

Eddie J. Aceves, MSW

  • Clinical Social Worker
  • Riverside, CA
National Provider Identifier
1376736249
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
108144 Issued in CA
Practice address
3125 Myers St
Riverside, CA 92503-5527
Phone
(951) 358-4840
Fax
(323) 728-9201
NPI assigned
Aug 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 108144 CA Primary

Addresses

Primary practice location

3125 Myers St
Riverside, CA 92503-5527

Mailing address

3125 Myers St
Riverside, CA 92503-5527
Phone (951) 358-4840

Other practice location 1

5835 S Eastern Ave
LA County DMH Specialized Foster Care Mental Health
Commerce, CA 90040-4001
Phone (323) 725-4625

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
108144CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1376736249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 MYERS ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035527",
            "telephone_number": "951-358-4840",
            "fax_number": "323-728-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 MYERS ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035527",
            "telephone_number": "951-358-4840",
            "fax_number": "323-728-9201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5835 S Eastern Ave",
            "address_2": "LA County DMH Specialized Foster Care Mental Health",
            "address_purpose": "LOCATION",
            "city": "Commerce",
            "state": "CA",
            "postal_code": "900404001",
            "country_code": "US",
            "telephone_number": "323-725-4625",
            "fax_number": "323-728-9201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACEVES",
        "first_name": "EDDIE",
        "middle_name": "J.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "108144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.