Paul Maldonado, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

102948 Issued in CA

Practice address

850 E Foothill Blvd
Rialto, CA 92376-5230

Phone

(909) 421-9301

Fax

(909) 421-9219

NPI assigned

Jul 19, 2016

Last updated

Aug 6, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• County of San Bernardino

  dba Department of Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Bernardino, CA
  • NPI 1164467023
  Medicare reassignment NPD
• County of San Bernardino

  dba Mesa Counseling Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rialto, CA
  • NPI 1326259151
  NPD
• County of San Bernardino

  dba Apple Valley Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Apple Valley, CA
  • NPI 1346950904
  NPD

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1396198941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 E FOOTHILL BLVD",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923765230",
            "telephone_number": "909-421-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 E FOOTHILL BLVD",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923765230",
            "telephone_number": "909-421-9301",
            "fax_number": "909-421-9219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "PAUL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-19",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "102948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YM0800X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorean E Mahlow
• Ayad Said Makar, M.D.
• Lee Malara, RN
• Denise Maldonado
• Elizabeth Marie Maldonado
• Caroline Enriquez Malijan
• Christine Mallari
• Hilda Mancilla, PA-C
• Shalise Manning
• Waahida Mansion

• Clinical Social Worker in Rialto, CA
• Providers in Rialto, 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 Aug 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.