Active NPI
Susan Reanne Gervais, ACSW
- Clinical Social Worker
- Hemet, CA
National Provider Identifier
1710556188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 107707
- Practice address
- 1105 E Florida Ave
Hemet, CA 92543-4512 - Phone
- (951) 436-5302
- NPI assigned
- Jun 21, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 107707 | CA | Primary |
Addresses
Primary practice location
1105 E Florida Ave
Hemet, CA 92543-4512
Mailing address
1287 Olive Tree LN Apt a
Hemet, CA 92543-5108
Phone (951) 385-8374
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
| License | State | Type | Specialty |
|---|---|---|---|
| 107707 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Alternatives, Incorporated | Past | Accepting new patients |
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.
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- NPI 1023221470
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689033600000",
"number": "1710556188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1287 OLIVE TREE LN APT A",
"city": "HEMET",
"state": "CA",
"postal_code": "925435108",
"telephone_number": "951-385-8374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 E FLORIDA AVE",
"city": "HEMET",
"state": "CA",
"postal_code": "925434512",
"telephone_number": "951-436-5302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERVAIS",
"first_name": "SUSAN",
"middle_name": "REANNE",
"credential": "ACSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-21",
"last_updated": "2023-07-11",
"certification_date": "2023-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "107707",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hemet, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.