Elsa Matsumoto, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

82305 Issued in CA

Practice address

600 N Mountain Ave Ste D204
Upland, CA 91786-4369

Phone

(626) 209-9965

NPI assigned

Aug 30, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Elsa Matsumoto Licensed Clinical Social Worker Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Upland, CA
  • NPI 1851014542
  NPD Authorized official
• Tri-City Mental Health Center

  • Case Management Agency
  • Pomona, CA
  • NPI 1255651501
  NPD (past)

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

{
    "created_epoch": "1377820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1922432541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 HIGHLAND AVE",
            "address_2": "PO BOX 1064",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910106119",
            "telephone_number": "626-209-9965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N MOUNTAIN AVE STE D204",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864369",
            "telephone_number": "626-209-9965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUMOTO",
        "first_name": "ELSA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-30",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW62950",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "82305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monique Idalis Martinez
• Raymond Martinez III
• Deryk Mason II, LVN
• Kristina Starr Matlock
• Caitlin Matsumoto, PA-C
• Matthew J Nykiel MD, Inc
• Jennipearl Anne Matzke
• Maulin Home Care Services,Iinc.
• Max V. Soliguen, M.D., Inc. Dba Kids First Pediatrics
• Corinne Erica Maxwell, PA-C

• Clinical Social Worker in Upland, CA
• Providers in Upland, 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 Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.