Individual provider Active NPI

Ruby Roman

  • Social Worker
  • Colton, CA
National Provider Identifier
1396508321
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
120403 Issued in CA
Practice address
1461 E Cooley Dr Ste 100
Colton, CA 92324-3921
Phone
(877) 527-7227
NPI assigned
Feb 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 120403 CA Primary

Addresses

Primary practice location

1461 E Cooley Dr Ste 100
Colton, CA 92324-3921

Mailing address

25910 Acero Ste 160
Mission Viejo, CA 92691-2777

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
120403CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1706745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1396508321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25910 ACERO STE 160",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926912777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 E COOLEY DR STE 100",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243921",
            "telephone_number": "877-527-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "RUBY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-01",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "120403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.