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NPI Code Detail

MEDICARE: BERTA ELENA RIVAS SANCHEZ LCSW

MEDICARE: BERTA ELENA RIVAS SANCHEZ LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker134629CA
2104100000XSocial Worker134629CA

General Provider Information

NPI Number : 1679109292
Entity Type Code : Individual
Provider Name (Legal Business Name) : BERTA ELENA RIVAS SANCHEZ LCSW
Provider Business Mailing Address
First Line : 25307 MAIN ST APT 2
Second Line :
City : BARSTOW
State : CA
Zip : 92311-9463
Country : US
Telephone Number : 442-280-5355
Fax Number :
Provider Business Practice Location Address
First Line : 16552 SUNHILL DR
Second Line :
City : VICTORVILLE
State : CA
Zip : 92395-4518
Country : US
Telephone Number : 442-280-5355
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2020
Last Update Date : 11/05/2025

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Directions to “ BERTA ELENA RIVAS SANCHEZ LCSW” Practice Location

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