Individual provider Active NPI

Yalittza Reyna

  • Clinical Social Worker
  • Rancho Cucamonga, CA
National Provider Identifier
1831487669
Registry record updated Jul 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW105220 Issued in CA
Practice address
10832 Laurel St Ste 102
Rancho Cucamonga, CA 91730-7688
Phone
(909) 987-1997
NPI assigned
Jul 13, 2011
Reactivated
Sep 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 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 LCSW105220 CA Primary

Addresses

Primary practice location

10832 Laurel St Ste 102
Rancho Cucamonga, CA 91730-7688

Mailing address

PO Box 1585
Rialto, CA 92377-1585
Phone (909) 307-4465

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
I20220111000663 CA Practitioner - Clinical Social Worker 8729470315 Reassigns benefits to 3 organizations
Practice locations: Rancho Cucamonga, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foothills Psychological Services IncGroup PAC ID 9436157534, 37 clinicians

Practice addresses (Care Compare)

954 W Foothill Blvd
Suite a
Upland, CA 91786-3782
Phone (909) 946-4222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW105220CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Psychological Services, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Mission City Community Network, Inc. CurrentSince Apr 22, 2024 Accepting new patients
Yrg Therapy, Licensed Clinical Social Worker Corporation Clinical Current Accepting new patients
Mission City Community Network, Inc. CurrentSince Apr 22, 2024 Accepting new patients
Tri-City Mental Health Authority PastSince Oct 22, 2019 Accepting new patients
Tri-City Mental Health Center Past Accepting new patients

Locations

5050 San Bernardino St
Montclair, CA 91763
Phone (909) 281-5800

8363 Reseda Blvd
Ste 11
Northridge, CA 91324
Phone 8188953100602

1550 N Park Ave
Pomona, CA 91768
Phone (909) 623-0791

10832 Laurel St
Ste 102
Rancho Cucamonga, CA 91730
Phone (909) 987-1997

15206 Parthenia St
Sepulveda, CA 91343

600 N Euclid Ave
Ste 204
Upland, CA 91786
Phone (909) 379-1513

954 W Foothill Blvd
Ste A
Upland, CA 91786
Phone (909) 946-4222

15201 Eleventh St
Ste 300
Victorville, CA 92395
Phone (760) 245-1640

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1831487669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1585",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923771585",
            "telephone_number": "909-307-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10832 LAUREL ST STE 102",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307688",
            "telephone_number": "909-987-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNA",
        "first_name": "YALITTZA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "deactivation_date": "2018-08-24",
        "reactivation_date": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW105220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.