Active NPI
Roger Delgado, PH.D
- Clinical Social Worker
- Fontana, CA
National Provider Identifier
1407997497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS4651
- Practice address
- 14055 Bancroft CT
Fontana, CA 92336-3510 - Phone
- (909) 822-9892
- Fax
- (909) 822-9892
- NPI assigned
- Feb 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | LCS4651 | CA | Primary |
Addresses
Primary practice location
14055 Bancroft CT
Fontana, CA 92336-3510
Mailing address
14055 Bancroft CT
Fontana, CA 92336-3510
Phone (909) 822-9892
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS4651 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pituck Medical Group, Inc. | 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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407997497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14055 BANCROFT CT",
"city": "FONTANA",
"state": "CA",
"postal_code": "923363510",
"telephone_number": "909-822-9892",
"fax_number": "909-822-9892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14055 BANCROFT CT",
"city": "FONTANA",
"state": "CA",
"postal_code": "923363510",
"telephone_number": "909-822-9892",
"fax_number": "909-822-9892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELGADO",
"first_name": "ROGER",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS4651",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fontana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.