Individual provider Active NPI

Rosa I Winter, LCSW

  • Clinical Social Worker
  • Montclair, CA
National Provider Identifier
1912104076
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS22924 Issued in CA
Practice address
5330 San Bernardino St
Montclair, CA 91763-2952
Phone
(909) 399-3776
Fax
(626) 405-6768
NPI assigned
Jun 29, 2007
Last updated
Aug 4, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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 LCS22924 CA Primary

Addresses

Primary practice location

5330 San Bernardino St
Montclair, CA 91763-2952

Mailing address

393 E Walnut St
3Rd Floor - PHR Systems
Pasadena, CA 91188-0001
Phone (626) 405-7914

Other names 1

  • Rosa I Gomez Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS22924CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1912104076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 E WALNUT ST",
            "address_2": "3RD FLOOR - PHR SYSTEMS",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911880001",
            "telephone_number": "626-405-7914",
            "fax_number": "626-405-6768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 SAN BERNARDINO ST",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632952",
            "telephone_number": "909-399-3776",
            "fax_number": "626-405-6768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTER",
        "first_name": "ROSA",
        "middle_name": "I",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS22924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSA",
            "last_name": "GOMEZ",
            "middle_name": "I",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Montclair, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; 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.