Daniel Roger Eberhardt, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS19058 Issued in CA

Practice address

1651 E 4TH St
Suite 128
Santa Ana, CA 92701-5164

Phone

(949) 874-5960

Fax

(714) 972-3744

NPI assigned

Oct 3, 2006

Last updated

Apr 23, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1730273988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CANTATA DR",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926925102",
            "telephone_number": "949-874-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 E 4TH ST",
            "address_2": "SUITE 128",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927015164",
            "telephone_number": "949-874-5960",
            "fax_number": "714-972-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERHARDT",
        "first_name": "DANIEL",
        "middle_name": "ROGER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS19058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Santa Ana, CA
• Providers in Santa Ana, 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 Apr 23, 2008; 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.