Individual provider Active NPI

Martha Eufracio, MSW, ASW

  • Clinical Social Worker
  • Pomona, CA
National Provider Identifier
1932585007
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ASW66012 Issued in CA
Practice address
1555 S Garey Ave
Pomona, CA 91766-5222
Phone
(909) 620-8088
NPI assigned
Jul 30, 2015
Last updated
Jul 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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 ASW66012 CA Primary

Addresses

Primary practice location

1555 S Garey Ave
Pomona, CA 91766-5222

Mailing address

6680 Avenida Michaelinda
Riverside, CA 92509-7227
Phone (909) 620-8088

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
I20190221001954 CA Practitioner - Clinical Social Worker 6901145796 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW66012CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sac Health System CurrentSince Mar 1, 2019 Accepting new patients
Sac Health System Current Accepting new patients
Sac Health System CurrentSince Mar 1, 2019 Accepting new patients

Locations

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

250 S G St
San Bernardino, CA 92410
Phone (909) 771-2990

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1932585007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6680 AVENIDA MICHAELINDA",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925097227",
            "telephone_number": "909-620-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 S GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917665222",
            "telephone_number": "909-620-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUFRACIO",
        "first_name": "MARTHA",
        "name_prefix": "Mrs.",
        "credential": "MSW, ASW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-30",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW66012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.