Individual provider Active NPI

Kenya Salas

  • Clinical Social Worker
  • Riverside, CA
National Provider Identifier
1679069678
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
123104 Issued in CA
Practice address
2085 Rustin Ave
Riverside, CA 92507-2498
Phone
(909) 440-0816
NPI assigned
Jul 3, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 123104 CA Primary

Addresses

Primary practice location

2085 Rustin Ave
Riverside, CA 92507-2498

Mailing address

PO Box 126
Bloomington, CA 92316-0126
Phone (909) 440-0816

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
I20250109001196 CA Practitioner - Clinical Social Worker 7719415454 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
123104CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Unicare Community Health Center, Inc. CurrentSince Jan 6, 2025 Accepting new patients
Unicare Community Health Center Inc CurrentSince Jan 6, 2025 Accepting new patients
Unicare Community Health Center Inc Current Accepting new patients

Locations

107 N McKinley St
Corona, CA 92879
Phone (951) 358-0141

24853 Alessandro Blvd
Ste 4
Moreno Valley, CA 92553
Phone (951) 571-8518

1151 E Walnut St
Ontario, CA 91761
Phone (909) 467-0797

437 N Euclid Ave
Ontario, CA 91762
Phone (909) 749-1835

1501 E Holt Ave
Ste A
Pomona, CA 91767
Phone (909) 623-3600

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": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1679069678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 126",
            "city": "BLOOMINGTON",
            "state": "CA",
            "postal_code": "923160126",
            "telephone_number": "909-440-0816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 RUSTIN AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072498",
            "telephone_number": "909-440-0816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAS",
        "first_name": "KENYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "123104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.