Individual provider Active NPI

Rafik William Philobos, L.C.S.W.

  • Clinical Social Worker
  • Corona, CA
National Provider Identifier
1972735173
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
25611 Issued in CA
Practice address
2275 S Main St Ste 101B&103
Corona, CA 92882-5303
Phone
(951) 279-3222
Fax
(951) 279-5222
NPI assigned
Aug 20, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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 25611 CA Primary

Addresses

Primary practice location

2275 S Main St Ste 101B&103
Corona, CA 92882-5303

Mailing address

2275 S Main St
Suite 201
Corona, CA 92882-5303
Phone (951) 279-3222

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
I20190311001852 CA Practitioner - Clinical Social Worker 0042559965 Practice locations: Corona, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25611CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra Counseling Psychotherapy, Inc. Current Accepting new patients

Locations

2275 S Main St
Ste 201
Corona, CA 92882
Phone (951) 279-1333

Organizations & group practices 7

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": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1972735173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 S MAIN ST",
            "address_2": "SUITE 201",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928825303",
            "telephone_number": "951-279-3222",
            "fax_number": "951-279-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 S MAIN ST STE 101B&103",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928825303",
            "telephone_number": "951-279-3222",
            "fax_number": "951-279-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILOBOS",
        "first_name": "RAFIK",
        "middle_name": "WILLIAM",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-20",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "25611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.