Individual provider Active NPI

Anthony Ramirez

  • Clinical Social Worker
  • Riverside, CA
National Provider Identifier
1730633694
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW108875 Issued in CA
Practice address
11801 Pierce St Ste 200
Riverside, CA 92505-4400
Phone
(951) 836-9444
Fax
(951) 848-0797
NPI assigned
Aug 9, 2016
Reactivated
Jan 24, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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 LCSW108875 CA Primary

Addresses

Primary practice location

11801 Pierce St Ste 200
Riverside, CA 92505-4400

Mailing address

11801 Pierce St Ste 200
Riverside, CA 92505-4400
Phone (951) 836-9444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • 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
I20230410000796 CA Practitioner - Clinical Social Worker 4688049471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15497 W Sand St
Victorville, CA 92392-2910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW108875CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Stormbreaker Wellness, Inc. Clinical CurrentSince Jan 14, 2025 Accepting new patients
High Desert Psychological Services Clinical CurrentSince Feb 17, 2023 Accepting new patients
Coast to Coast Psychological Services Clinical Past Accepting new patients

Locations

11801 Pierce St
Ste 200
Riverside, CA 92505
Phone (323) 547-2662

3610 Central Ave
Ste 500
Riverside, CA 92506
Phone (442) 327-9311

15497 W Sand St
Victorville, CA 92392
Phone (442) 327-9311

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1730633694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11801 PIERCE ST STE 200",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925054400",
            "telephone_number": "951-836-9444",
            "fax_number": "951-848-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 PIERCE ST STE 200",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925054400",
            "telephone_number": "951-836-9444",
            "fax_number": "951-848-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMIREZ",
        "first_name": "ANTHONY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-09",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "deactivation_date": "2023-01-14",
        "reactivation_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW108875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.