Individual provider Active NPI

Anthony Manuel Paez, ASW

  • Mental Health Counselor
  • San Bernardino, CA
National Provider Identifier
1629608229
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
572 N Arrowhead Ave
San Bernardino, CA 92401-1251
Phone
(909) 266-2700
NPI assigned
Jan 22, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

572 N Arrowhead Ave
San Bernardino, CA 92401-1251

Mailing address

572 N Arrowhead Ave
San Bernardino, CA 92401-1251
Phone (909) 266-2700

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
I20230103002869 CA Practitioner - Clinical Social Worker 5496125635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
High Desert Psychological ServicesGroup PAC ID 2860819125, 82 clinicians

Practice addresses (Care Compare)

15497 W Sand St
Victorville, CA 92392-2910
Phone (442) 327-9311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
High Desert Psychological Services CurrentSince Oct 19, 2022 Accepting new patients
Coast to Coast Psychological Services Mental Health Past Accepting new patients

Locations

3610 Central Ave
Ste 500
Riverside, CA 92506
Phone (442) 327-9311

15497 W Sand St
Victorville, CA 92392
Phone (442) 327-9311

Organizations & group practices 2

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": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1629608229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "572 N ARROWHEAD AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011251",
            "telephone_number": "909-266-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "572 N ARROWHEAD AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011251",
            "telephone_number": "909-266-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAEZ",
        "first_name": "ANTHONY",
        "middle_name": "MANUEL",
        "credential": "ASW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-22",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "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.