Cheryl Lynn Polyudhapoom, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

98339 Issued in CA

Practice address

6931 Water Wheel Dr
Bakersfield, CA 93313-4524

Phone

(661) 421-4656

NPI assigned

Aug 20, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Cheryl Lynn Rubiaco Former name

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

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  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1471651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1699220509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6931 WATER WHEEL DR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933134524",
            "telephone_number": "661-421-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6931 WATER WHEEL DR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933134524",
            "telephone_number": "661-421-4656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1430 Truxtun Ave Fl 5",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "933015243",
            "country_code": "US",
            "telephone_number": "661-665-6077 x702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLYUDHAPOOM",
        "first_name": "CHERYL",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-20",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "65803",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "98339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "cpolyudhapoom@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "cpolyudhapoom@gmail.com",
            "address_1": "6931 Water Wheel Dr",
            "city": "Bakersfield",
            "state": "CA",
            "country_code": "US",
            "postal_code": "933134524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "RUBIACO",
            "middle_name": "LYNN",
            "credential": "MSW, ASW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Ashley Angie Ponce
• Felicia Ponce
• Isabella Faith Joyous Ponce
• Jesus Ponce

• Clinical Social Worker in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.