Individual provider Active NPI

Donna Caudillo, LCSW

  • Clinical Social Worker
  • San Bernardino, CA
National Provider Identifier
1689137176
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW134189 Issued in CA
Practice address
658 E Brier Dr Ste 200
San Bernardino, CA 92408-2847
Phone
(909) 501-0700
NPI assigned
Apr 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 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 LCSW134189 CA Primary

Addresses

Primary practice location

658 E Brier Dr Ste 200
San Bernardino, CA 92408-2847

Mailing address

658 E Brier Dr Ste 200
San Bernardino, CA 92408-2847
Phone (909) 501-0700

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
LCSW134189CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Bernardino CurrentSince Feb 8, 2023 Accepting new patients

Locations

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

658 E Brier Dr
Ste 200
San Bernardino, CA 92408
Phone (909) 501-0700

Organizations & group practices 1

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": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1689137176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 E BRIER DR STE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082847",
            "telephone_number": "909-501-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 E BRIER DR STE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082847",
            "telephone_number": "909-501-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAUDILLO",
        "first_name": "DONNA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW134189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.