Kelly Rivadeneyra, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

122911 Issued in CA

Practice address

150 Valpreda Rd
San Marcos, CA 92069-2973

Phone

(760) 736-6780

NPI assigned

Feb 28, 2019

Last updated

Aug 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, CA2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North County Health Project IncGroup PAC ID 2769390939, 56 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/mhcp/r4/
• FHIR API: https://fhir4.healow.com/fhir/r4/HBFIAA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North County Health Project Inc

  dba TrueCare

  • Federally Qualified Health Center (FQHC)
  • San Marcos, CA
  • NPI 1245246917
  Medicare reassignment Care Compare group NPD
• Newark Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
  • NPI 1740345693
  Medicare reassignment NPD
• North County Health Project Inc

  dba TrueCare

  • Federally Qualified Health Center (FQHC)
  • Perris, CA
  • NPI 1417321746
  NPD
• North County Health Project Inc

  dba TrueCare

  • Federally Qualified Health Center (FQHC)
  • San Marcos, CA
  • NPI 1588489975
  NPD
• Newark Community Health Centers, Inc

  dba Ironbound Medical & Dental Center

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
  • NPI 1366993586
  NPD
• Mental Health Clinic of Passaic Inc

  • Community/Behavioral Health Agency
  • Clifton, NJ
  • NPI 1619009701
  NPD (past)

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1790242469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 VALPREDA RD",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692973",
            "telephone_number": "760-736-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 VALPREDA RD",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692973",
            "telephone_number": "760-736-6780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Nutley",
            "state": "NJ",
            "postal_code": "071102311",
            "country_code": "US",
            "telephone_number": "973-667-1884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVADENEYRA",
        "first_name": "KELLY",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-28",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05971300",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "122911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Electra Riley, PTA
• Adriana Rios, PPS
• Faith Risinger
• Toni A Risley, PT
• Matthew Francis Ritchie
• Aitana Cecilia Rivera
• Angelina Rivera
• Midori Rivera, M.D.
• Alison Roberson
• Rachel Melinda Roberson, RBT

• Clinical Social Worker in San Marcos, CA
• Providers in San Marcos, 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 Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.