Individual provider Active NPI

Roberta Jo Fox

  • Clinical Social Worker
  • Rialto, CA
National Provider Identifier
1891378840
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
129304 Issued in CA
Practice address
850 E Foothill Blvd
Rialto, CA 92376-5230
Phone
(909) 421-9491
Fax
(909) 421-5650
NPI assigned
Apr 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 129304 CA Primary
Social Worker 104100000X

Addresses

Primary practice location

850 E Foothill Blvd
Rialto, CA 92376-5230

Mailing address

850 E Foothill Blvd
Rialto, CA 92376-5230
Phone (909) 421-9491

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
I20250813002116 CA Practitioner - Clinical Social Worker 4880192376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

303 E Vanderbilt Way
FL 3
San Bernardino, CA 92415-0026

500 W Jefferson St
Louisville, KY 40202-2881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
129304CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Bernardino Current Accepting new patients
County of San Bernardino CurrentSince May 31, 2025 Accepting new patients
County of San Bernardino CurrentSince May 31, 2025 Accepting new patients

Locations

1330 E Cooley Dr
Colton, CA 92324
Phone (909) 423-0750

850 E Foothill Blvd
Rialto, CA 92376
Phone (909) 421-9200

303 E Vanderbilt Way
Sn Bernrdno, CA 92415
Phone (909) 388-0801

Organizations & group practices 3

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": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1891378840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 E FOOTHILL BLVD",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923765230",
            "telephone_number": "909-421-9491",
            "fax_number": "909-421-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 E FOOTHILL BLVD",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923765230",
            "telephone_number": "909-421-9491",
            "fax_number": "909-421-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "ROBERTA",
        "middle_name": "JO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "129304",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rialto, CA

Sources for this page

Verify at the official NPI Registry.