Individual provider Active NPI

Zuelika Cristina Xicotencatl

  • Clinical Social Worker
  • San Bernardino, CA
National Provider Identifier
1467583864
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
900 E Gilbert St
San Bernardino, CA 92415-1004
Phone
(909) 387-6942
Fax
(909) 386-0750
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

900 E Gilbert St
San Bernardino, CA 92415-1004

Mailing address

700 E Gilbert St
San Bernardino, CA 92415-1003
Phone (909) 387-7378

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150908003006 CA Practitioner - Clinical Social Worker 1658687504 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Bernardino Current Accepting new patients
County of San Bernardino CurrentSince Jan 1, 2022 Accepting new patients
County of San Bernardino CurrentSince Jan 1, 2022 Accepting new patients

Locations

17053 Foothill Blvd
Bldg B
Fontana, CA 92335
Phone (909) 347-1300

303 E Vanderbilt Way
Sn Bernrdno, CA 92415
Phone (909) 388-0801

900 E Gilbert St
Sn Bernrdno, CA 92415
Phone (909) 387-7118

Organizations & group practices 3

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190937600000",
    "number": "1467583864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E GILBERT ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924151003",
            "telephone_number": "909-387-7378",
            "fax_number": "909-387-7386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E GILBERT ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924151004",
            "telephone_number": "909-387-6942",
            "fax_number": "909-386-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XICOTENCATL",
        "first_name": "ZUELIKA",
        "middle_name": "CRISTINA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.