Individual provider Active NPI

Nancy Dara Deutsch, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1013169390
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS11547 Issued in CA
Practice address
1238 Cypress Ave
San Diego, CA 92103-4406
Phone
(619) 300-6069
Fax
(619) 295-0540
NPI assigned
Oct 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

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 LCS11547 CA Primary

Addresses

Primary practice location

1238 Cypress Ave
San Diego, CA 92103-4406

Mailing address

1238 Cypress Ave
San Diego, CA 92103-4406
Phone (619) 300-6069

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
I20090202000313 CA Practitioner - Clinical Social Worker 5193889400 Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1238 Cypress Ave
San Diego, CA 92103-4406
Phone (619) 295-1175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS11547CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1013169390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1238 CYPRESS AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034406",
            "telephone_number": "619-300-6069",
            "fax_number": "619-295-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1238 CYPRESS AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034406",
            "telephone_number": "619-300-6069",
            "fax_number": "619-295-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEUTSCH",
        "first_name": "NANCY",
        "middle_name": "DARA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-16",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS11547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.