Individual provider Active NPI

William Thompson Cloake IV, MFTI

  • Marriage & Family Therapist
  • Riverside, CA
National Provider Identifier
1689824179
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
1020 Iowa Ave Ste B
Riverside, CA 92507-2105
Phone
(951) 358-4437
Fax
(951) 358-4479
NPI assigned
Sep 22, 2008
Last updated
Jun 14, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X NU Primary

Addresses

Primary practice location

1020 Iowa Ave Ste B
Riverside, CA 92507-2105

Mailing address

PO Box 7109
Riverside, CA 92513-7109
Phone (951) 358-6957

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
I20240713000242 CA Practitioner - Marriage and Family Therapist 1557806684 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for New Directions, Inc. CurrentSince Apr 10, 2024 Accepting new patients
Stephen M Pumphrey Licensed Clinical Social Workers Inc PastSince Dec 25, 2018 Accepting new patients

Locations

23201 Mill Creek Dr
Ste 220
Laguna Hills, CA 92653
Phone (949) 460-5320

7177 Brockton Ave
Ste 111
Riverside, CA 92506
Phone (949) 460-5322

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1689824179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7109",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925137109",
            "telephone_number": "951-358-6957",
            "fax_number": "951-358-6957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 IOWA AVE STE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072105",
            "telephone_number": "951-358-4437",
            "fax_number": "951-358-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOAKE",
        "first_name": "WILLIAM",
        "middle_name": "THOMPSON",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "MFTI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-22",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.