Individual provider Active NPI

Anthony Scott Holmquist-Burks, LCSW 128161

  • Clinical Social Worker
  • Palm Springs, CA
National Provider Identifier
1639691520
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
128161 Issued in CA
Practice address
150 District Center Dr
Palm Springs, CA 92264-3626
Phone
(760) 883-2715
NPI assigned
Jul 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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 128161 CA Primary

Addresses

Primary practice location

150 District Center Dr
Palm Springs, CA 92264-3626

Mailing address

41240 Prospect CT
Indio, CA 92203-3226
Phone (651) 276-4759

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
128161CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1639691520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41240 PROSPECT CT",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922033226",
            "telephone_number": "651-276-4759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 DISTRICT CENTER DR",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922643626",
            "telephone_number": "760-883-2715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMQUIST-BURKS",
        "first_name": "ANTHONY",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "LCSW 128161",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-12",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "128161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.