Myra Ivette Tyler, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW76160 Issued in CA

Practice address

6601 Stephens Ranch Rd
La Verne, CA 91750-1146

Phone

(909) 392-2038

NPI assigned

Sep 8, 2010

Last updated

Jan 4, 2021By 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 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1841507027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2218 WHITE ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073260",
            "telephone_number": "626-590-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 STEPHENS RANCH RD",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917501146",
            "telephone_number": "909-392-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "MYRA",
        "middle_name": "IVETTE",
        "name_prefix": "Miss",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-08",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW76160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "KP.org",
            "affiliation": "N",
            "address_1": "6601 Stephens Ranch Rd",
            "city": "LA Verne",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917501146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tri-City Mental Health Authority
• Tri-City Mental Health Authority
• Tri-City Mental Health Authority
• Luiza Triches Rodrigues
• Jessica Turner
• Tracey Gail Uditsky
• Stephanie Untalan, COTA/L
• Carla Ureno, M.S, MFTI
• Utopia Optometry
• Joana Valencia

• Clinical Social Worker in La Verne, CA
• Providers in La Verne, 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 Jan 4, 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.