Emmanuel Jacob Micklus, PSS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

MPSS-PXLOZN Issued in CA

Practice address

2251 San Diego Ave Ste A150
San Diego, CA 92110-2983

Phone

(619) 800-9856

NPI assigned

Aug 27, 2026

Last updated

Aug 27, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1787788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1033027578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2251 SAN DIEGO AVE STE A150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102983",
            "telephone_number": "619-800-9856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 SAN DIEGO AVE STE A150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102983",
            "telephone_number": "619-800-9856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKLUS",
        "first_name": "EMMANUEL",
        "middle_name": "JACOB",
        "credential": "PSS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-08-27",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-PXLOZN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Lesley Mick, NP
• Aaron C Mickaelian
• Emma Malia Mickel
• Makaila Rose Mickel
• Kelly Mickler, MS, CCC-SLP
• Micronoma Inc. (Micronoma)
• Mid-County Physicians Ipa
• Midcounty Surgical Associates LP a California Limited Partnership
• Douglas Malcom Middleton, M.D.
• Michael L Middleton, CRNA

• Peer Specialist in San Diego, CA
• Providers in San Diego, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.