Individual provider Active NPI

Cynthia Moreno, LCSW

  • Clinical Social Worker
  • La Verne, CA
National Provider Identifier
1780966077
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW79247 Issued in CA
Practice address
6631 Stephens Ranch Rd
La Verne, CA 91750-1146
Phone
(909) 703-5501
NPI assigned
Sep 13, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 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 LCSW79247 CA Primary

Addresses

Primary practice location

6631 Stephens Ranch Rd
La Verne, CA 91750-1146

Mailing address

6631 Stephens Ranch Rd
La Verne, CA 91750-1146
Phone (909) 703-5501

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

LicenseStateTypeSpecialty
LCSW79247CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1780966077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6631 STEPHENS RANCH RD",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917501146",
            "telephone_number": "909-703-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6631 STEPHENS RANCH RD",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917501146",
            "telephone_number": "909-703-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "CYNTHIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW79247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Verne, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.