Individual provider Active NPI

Rachel Elizabeth Fernelius, LCSW

  • Clinical Social Worker
  • Riverside, CA
National Provider Identifier
1679356406
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
26096 Issued in CA
Practice address
6833 Indiana Ave Ste 101
Riverside, CA 92506-4223
Phone
(657) 346-6319
Fax
(951) 269-4184
NPI assigned
Aug 15, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 989667 CO
Community/Behavioral Health Agency 251S00000X 26096 CA
Clinical Social Worker 1041C0700X 26096 CA Primary

Addresses

Primary practice location

6833 Indiana Ave Ste 101
Riverside, CA 92506-4223

Mailing address

2480 Irvine Blvd Apt 354
Tustin, CA 92782-8037
Phone (949) 751-8443

Other practice location 1

2480 Irvine Blvd Apt 354
Tustin, CA 92782-8037
Phone (949) 751-8443

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
I20230922002757 CA Practitioner - Clinical Social Worker 5395199491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nebula Health, LLCGroup PAC ID 8820482805, 17 clinicians

Practice addresses (Care Compare)

5900 Brockton Ave
Riverside, CA 92506-1862
Phone (951) 900-7681

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
989667COMDClinical Social Worker
26095CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Nebula Health, LLC CurrentSince Aug 9, 2023 Accepting new patients
Nebula Health, P. C. PastSince Nov 12, 2023 Accepting new patients

Locations

31872 Coast Hwy
Fl 2
Laguna Beach, CA 92651
Phone (949) 399-7504

23228 Madero
Mission Viejo, CA 92691
Phone (949) 454-3940

6833 Indiana Ave
Ste 101
Riverside, CA 92506
Phone (657) 346-6319

5900 Brockton Ave
Riverside, CA 92506
Phone (800) 992-0901

806 Avenida Pico
#I330
San Clemente, CA 92673

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": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1679356406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 IRVINE BLVD APT 354",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927828037",
            "telephone_number": "949-751-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6833 INDIANA AVE STE 101",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064223",
            "telephone_number": "657-346-6319",
            "fax_number": "951-269-4184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2480 Irvine Blvd Apt 354",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927828037",
            "country_code": "US",
            "telephone_number": "949-751-8443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNELIUS",
        "first_name": "RACHEL",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "989667",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "26096",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "26096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.