KELLY RIVADENEYRA MSW, LCSW
NPI 1790242469
Social Worker - Clinical in San Marcos, CA

Q: What is Kelly Rivadeneyra's NPI number?

The NPI number for Kelly Rivadeneyra is 1790242469. It was assigned to this individual provider in the NPPES registry on February 28, 2019.

Q: What is Kelly Rivadeneyra's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Rivadeneyra was last updated on August 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 28, 2019PECOS EnrolledAccepts Medicare Assignment

150 VALPREDA RD, SAN MARCOS, CA 92069(760) 736-6780 Get Directions Write a Review

NPPES record last updated: August 26, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 8, 2024, Oct 13, 2021, Apr 8, 2021 and 1 more (4 updates tracked since 2019).

On this page

About Kelly Rivadeneyra Msw, Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY RIVADENEYRA MSW, LCSW (NPI 1790242469) is an individual clinical provider in San Marcos, California, licensed in California (122911) and active in the NPI registry since February 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Nutley, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1790242469

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameKELLY RIVADENEYRACredential: MSW, LCSW

Location Address150 VALPREDA RDSan Marcos, CA 92069-2973

Mailing Address150 Valpreda RdSan Marcos, CA 92069-2973 · (760) 736-6767

Phone(760) 736-6780

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateFebruary 28, 2019

Last NPPES UpdateAugust 26, 20244 updates tracked since enumeration

NPPES CertifiedAugust 26, 2024

✔ NPI 1790242469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

Licenses✔ Licensed in CA · 122911✔ Licensed in NJ · 44SC05971300

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

150 VALPREDA RD, San Marcos, CA 92069

Open in Google Maps ↗

Secondary Practice Location 1

Location 1169 Chestnut StNutley, NJ 07110-2311 · Phone (973) 667-1884

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Rivadeneyra Msw, Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4587072103

PECOS Enrollment IDI20240926003265

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Kelly Rivadeneyra reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

North County Health Project Inc

Same address

Federally Qualified Health Center (FQHC)

150 VALPREDA RD
San Marcos, CA 92069

Reassigned Medicare billing, California enrollment
126 clinicians in this Medicare group

NPI 1245246917 (760) 736-6700

Newark Community Health Centers, Inc

2,412 mi

Federally Qualified Health Center (FQHC)

92-96 FERRY STREET
Newark, NJ 07105

Reassigned Medicare billing, New Jersey enrollment
172 clinicians in this Medicare group

NPI 1366993586 (973) 483-1300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92069 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $62.10 – $184.71

Typical copayment $0.00 (range $15.52 – $46.17)

Most-billed visit code NA

Established Patient

$76.87 typical visit price

range $20.62 – $151.42

Typical copayment $19.21 (range $5.15 – $37.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GREGORY M SMITH

Dentist (General Practice)