Individual provider Active NPI

Sacha B Wisznia

  • Clinical Social Worker
  • San Bernardino, CA
National Provider Identifier
1407384308
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
73229 Issued in CA
Practice address
900East Gilbert Street Cottage 4
San Bernardino, CA 92415-4564
Phone
(909) 387-7024
NPI assigned
May 23, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 73229 CA Primary

Addresses

Primary practice location

900East Gilbert Street Cottage 4
San Bernardino, CA 92415-4564

Mailing address

900 E Gilbert St Ste 4
San Bernardino, CA 92415-0936
Phone (909) 387-7406

Other practice location 1

1901 Orange Tree Ln
Redlands, CA 92374-4564
Phone (909) 307-1204

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

Practice roles

OrganizationSpecialtyStatusNew patients
Act Family Counseling Incorporated Past 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": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1407384308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E GILBERT ST STE 4",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150936",
            "telephone_number": "909-387-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900EAST GILBERT STREET COTTAGE 4",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924154564",
            "telephone_number": "909-387-7024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 Orange Tree Ln",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923744564",
            "country_code": "US",
            "telephone_number": "909-307-1204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISZNIA",
        "first_name": "SACHA",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-23",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "73229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.