Individual provider Active NPI

Maureen Leddy Pujols, LCSW

  • Clinical Social Worker
  • Rialto, CA
National Provider Identifier
1508992884
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS26531 Issued in CA
Practice address
850 E. Foothill Blvd
Rialto, CA 92376
Phone
(909) 421-9300
Fax
(909) 382-3105
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X ASW20322 CA
Clinical Social Worker 1041C0700X ASW20322 CA
Clinical Social Worker 1041C0700X LCS26531 CA Primary

Addresses

Primary practice location

850 E. Foothill Blvd
Rialto, CA 92376

Mailing address

268 W. Hospitality LN
Suite 400
San Bernardino, CA 92415-0026
Phone (909) 421-9300

Other names 1

  • Maureen Virgina Leddy Former name

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

State licenses

LicenseStateTypeSpecialty
ASW20322CAMDClinical Social Worker
LCS26531CAMDClinical Social Worker
26531CAMDLicensed Psychiatric Technician

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1508992884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 W. HOSPITALITY LN",
            "address_2": "SUITE 400",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150026",
            "telephone_number": "909-421-9300",
            "fax_number": "909-382-3105"
        },
        {
            "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": "92376",
            "telephone_number": "909-421-9300",
            "fax_number": "909-382-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUJOLS",
        "first_name": "MAUREEN",
        "middle_name": "LEDDY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW20322",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW20322",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS26531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAUREEN",
            "last_name": "LEDDY",
            "middle_name": "VIRGINA",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rialto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.