Individual provider Active NPI

Veronica Loera

  • Clinical Social Worker
  • San Bernardino, CA
National Provider Identifier
1972774792
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW28333 Issued in CA
Practice address
225 W Hospitality LN Ste 208D
San Bernardino, CA 92408
Phone
(909) 609-6596
NPI assigned
Mar 19, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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 LCSW28333 CA Primary

Addresses

Primary practice location

225 W Hospitality LN Ste 208D
San Bernardino, CA 92408

Mailing address

225 W Hospitality LN Ste 208D
San Bernardino, CA 92408-3245
Phone (909) 609-6596

Other names 1

  • Veronica Matuzima Former name

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
I20141125000516 CA Practitioner - Clinical Social Worker 0941522148 Practice locations: San Bernardino, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW28333CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1972774792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 W HOSPITALITY LN STE 208D",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083245",
            "telephone_number": "909-609-6596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 W HOSPITALITY LN STE 208D",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92408",
            "telephone_number": "909-609-6596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOERA",
        "first_name": "VERONICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-19",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW28333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VERONICA",
            "last_name": "MATUZIMA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.