Individual provider Active NPI

Stephanie Ramirez

  • Clinical Social Worker
  • Fontana, CA
National Provider Identifier
1720554306
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104749 Issued in CA
Practice address
14677 Merrill Ave
Fontana, CA 92335
Phone
(951) 643-2340
NPI assigned
Oct 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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 104749 CA Primary

Addresses

Primary practice location

14677 Merrill Ave
Fontana, CA 92335

Mailing address

14677 Merrill Ave
Fontana, CA 92335

Other identifiers 1

IdentifierTypeStateIssuer
941735271MedicaidCA

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
I20220601001904 CA Practitioner - Clinical Social Worker 4082092168 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104749CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Laguna Beach Community Clinic, Inc. CurrentSince Feb 12, 2022 Accepting new patients
Alondra Loya PastSince Jun 15, 2025 Accepting new patients

Locations

362 3rd St
Laguna Beach, CA 92651
Phone (949) 494-0761

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": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1720554306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14677 MERRILL AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "92335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14677 MERRILL AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "92335",
            "telephone_number": "951-643-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMIREZ",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "104749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "941735271",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.