Myriam Cubillo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

80882 Issued in CA

Practice address

550 E Hospitality LN Ste 100
San Bernardino, CA 92408-4205

Phone

(714) 795-7493

NPI assigned

Sep 7, 2018

Sex

Female

Sole proprietor

No

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)

Enrolled

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

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617408000000",
    "number": "1801379672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 577572",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953577572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E HOSPITALITY LN STE 100",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924084205",
            "telephone_number": "714-795-7493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUBILLO",
        "first_name": "MYRIAM",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-07",
        "last_updated": "2021-04-03",
        "certification_date": "2021-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "80882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Cruz
• Zoraya Cruz I
• Crystal Ridge Recovery
• Crystal's Senior Services LLC (Crystal's Senior Services)
• Peter Csapoczi, MD
• Iliana Cuellar, D.D.S
• Moses Rueben Cuellar
• Amanda Cuevas
• Ileen Cuevas
• Jonathan Cuevas

• Clinical Social Worker in San Bernardino, CA
• Providers in San Bernardino, 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 3, 2021; 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.