Active NPI
Lisa Bouzaglou
- Clinical Social Worker
- Riverside, CA
National Provider Identifier
1821305277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 70108
- Practice address
- 4344 Latham St Ste 110
Riverside, CA 92501-1773 - Phone
- (951) 270-4878
- NPI assigned
- Sep 7, 2010
- Last updated
- Sep 11, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 70108 | CA | Primary |
Addresses
Primary practice location
4344 Latham St Ste 110
Riverside, CA 92501-1773
Mailing address
4344 Latham St Ste 110
Riverside, CA 92501-1773
Phone (951) 270-4878
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 70108 | Other | CA | LCSW |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 70108 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789084800000",
"number": "1821305277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4344 LATHAM ST STE 110",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925011773",
"telephone_number": "951-270-4878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4344 LATHAM ST STE 110",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925011773",
"telephone_number": "951-270-4878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUZAGLOU",
"first_name": "LISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-07",
"last_updated": "2026-09-11",
"certification_date": "2026-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "70108",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "70108",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.