Active NPI
Melanie Mota
- Clinical Social Worker
- Banning, CA
National Provider Identifier
1902544679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 116160
- Practice address
- 940 E Williams St Ste 102
Banning, CA 92220-5848 - Phone
- (951) 588-2553
- Fax
- (951) 755-8992
- NPI assigned
- May 23, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 116160 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | 116160 | CA | Primary |
Addresses
Primary practice location
940 E Williams St Ste 102
Banning, CA 92220-5848
Mailing address
940 E Williams St Ste 102
Banning, CA 92220-5848
Phone (951) 588-2553
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 |
|---|---|---|---|
| 116160 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692316800000",
"number": "1902544679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "940 E WILLIAMS ST STE 102",
"city": "BANNING",
"state": "CA",
"postal_code": "922205848",
"telephone_number": "951-588-2553",
"fax_number": "951-755-8992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 E WILLIAMS ST STE 102",
"city": "BANNING",
"state": "CA",
"postal_code": "922205848",
"telephone_number": "951-588-2553",
"fax_number": "951-755-8992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOTA",
"first_name": "MELANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-23",
"last_updated": "2023-08-18",
"certification_date": "2023-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "116160",
"primary": false
},
{
"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": "116160",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Banning, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.