AMANDA LUCERO BERTOLDO (LCSW) – Mental Health Counselor, NPI 1114367687

AMANDA LUCERO BERTOLDO (LCSW) is a healthcare provider. based in Riverside, California. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 94532 (CA). The NPI Number for AMANDA LUCERO BERTOLDO (LCSW) is 1114367687

Main info

Female
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA LUCERO BERTOLDO (LCSW)
NPI
1114367687
Phone
(951) 955-7118
Address
3801 University Ave
Enumeration Date
28 June 2013
Last Update Date
9 February 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4423279311
Graduation Year
2016 (10 years ago)
PAC ID
6406264068
Group Practice PAC ID
2860819125
Professional Enrollment ID
I20210420001199
Address ID
CA923922910VI15497STXX400

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness85
Years active:12State licenses:2Other namesUpdated within 12 months

4,987 CLINICAL SOCIAL WORKER in CA

Provider Addresses for AMANDA LUCERO BERTOLDO (LCSW)

  • 3801 University Ave

    400

    Riverside, CA 925013247

    Phone: (951) 955-7118

    Type: Location

  • 3125 MYERS ST

    RIVERSIDE, CA 925035527

    Phone: (951) 358-4840

    Type: Mailing

  • 14075 HESPERIA RD.

    HESPERIA, CA 92345

    Phone: (760) 810-0000

    Type: Mailing

  • 14135 MAIN ST. HESPERIA SUITE 301

    HESPERIA, CA 92345

    Phone: (866) 205-3595

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-04-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210420001199IClinical Social WorkerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92501)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860819125View full group profile
NameSpecialtyState
Marriage And Family TherapistCA
Mental Health CounselorCA
Clinical Social WorkerCA
Clinical Social WorkerCA
Clinical Social WorkerCA
Clinical Social WorkerCA
Clinical Social WorkerCA
Clinical Social WorkerCA
Marriage And Family TherapistCA
Marriage And Family TherapistCA

Reviews

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Frequently asked questions

What identifier follows AMANDA LUCERO BERTOLDO (LCSW) across health systems?
The NPI 1114367687 uniquely identifies AMANDA LUCERO BERTOLDO (LCSW) in U.S. healthcare data.
Is AMANDA LUCERO BERTOLDO (LCSW)'s NPI status active today?
Active status means AMANDA LUCERO BERTOLDO (LCSW)'s NPI record is not deactivated in the public file.
What type of care does AMANDA LUCERO BERTOLDO (LCSW) provide?
AMANDA LUCERO BERTOLDO (LCSW)'s profile centers on Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Is AMANDA LUCERO BERTOLDO (LCSW) tied to Riverside, California?
If you are local to Riverside, California, AMANDA LUCERO BERTOLDO (LCSW) may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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