Individual provider Active NPI

Ashley C Rotter

  • Clinical Social Worker
  • Ontario, CA
National Provider Identifier
1538463658
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 69501 Issued in CA
Practice address
855 N Euclid Ave
Ontario, CA 91762-2729
Phone
(909) 983-2020
Fax
(909) 983-6847
NPI assigned
Jan 4, 2011
Last updated
Jan 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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 LCSW 69501 CA Primary

Addresses

Primary practice location

855 N Euclid Ave
Ontario, CA 91762-2729

Mailing address

855 N Euclid Ave
Ontario, CA 91762-2729
Phone (909) 983-2020

Other identifiers 1

IdentifierTypeStateIssuer
1942323563MedicaidCA

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
LCSW 69501CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1538463658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 N EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917622729",
            "telephone_number": "909-983-2020",
            "fax_number": "909-983-6847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 N EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917622729",
            "telephone_number": "909-983-2020",
            "fax_number": "909-983-6847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTTER",
        "first_name": "ASHLEY",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-04",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW 69501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942323563",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.