Individual provider Active NPI

Rose Mary Ornelas

  • Clinical Social Worker
  • Fresno, CA
National Provider Identifier
1760535603
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS21728 Issued in CA
Practice address
4468 E Cesar Chavez Blvd
Fresno, CA 93702-3605
Phone
(559) 600-6083
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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 LCS21728 CA Primary

Addresses

Primary practice location

4468 E Cesar Chavez Blvd
Fresno, CA 93702-3605

Mailing address

4411 E Kings Canyon Rd
Fresno, CA 93702-3604
Phone (559) 600-6083

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
I20050818001140 CA Practitioner - Clinical Social Worker 0345270336 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS21728CAMDClinical Social Worker
21728CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Fresno CurrentSince May 6, 2015 Accepting new patients
County of Fresno Clinical CurrentSince May 6, 2015 Accepting new patients
Fresno County PastSince Oct 1, 2023 Accepting new patients

Locations

4441 E Kings Canyon Rd
Fresno, CA 93702
Phone (559) 453-4099

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1760535603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 E KINGS CANYON RD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937023604",
            "telephone_number": "559-600-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4468 E CESAR CHAVEZ BLVD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937023605",
            "telephone_number": "559-600-6083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORNELAS",
        "first_name": "ROSE",
        "middle_name": "MARY",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS21728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.