Individual provider Active NPI

Maysun Khan, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1033519632
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
91572 Issued in CA
Practice address
1963 4TH Ave
San Diego, CA 92101-2394
Phone
(619) 233-3432
NPI assigned
Sep 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 71910 CA
Clinical Social Worker 1041C0700X 91572 CA Primary

Addresses

Primary practice location

1963 4TH Ave
San Diego, CA 92101-2394

Mailing address

1963 4TH Ave
San Diego, CA 92101-2394
Phone (619) 233-3432

Other practice location 1

333 H St Ste 2010
Chula Vista, CA 91910-5556
Phone (619) 906-5435

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
I20201001002912 CA Practitioner - Clinical Social Worker 6305265869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Centers of San Diego IncGroup PAC ID 3476446378, 299 clinicians

Practice addresses (Care Compare)

3514 30TH St
San Diego, CA 92104-4120
Phone (619) 515-2424

3544 30TH St
San Diego, CA 92104-4120
Phone (619) 515-2424

3705 Mission Blvd
San Diego, CA 92109-7104
Phone (619) 515-2444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71910CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Sep 24, 2020 Accepting new patients
Family Health Centers of San Diego, Inc. CurrentSince Sep 24, 2020 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Community Research Foundation Inc Past Accepting new patients
Community Research Foundation Inc Clinical Past Accepting new patients
Family Health Centers of San Diego, Inc PastSince Jun 7, 2020 Accepting new patients

Locations

333 H St
Ste 2010
Chula Vista, CA 91910
Phone (619) 906-5435

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1033519632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1963 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012394",
            "telephone_number": "619-233-3432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1963 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012394",
            "telephone_number": "619-233-3432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 H St Ste 2010",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919105556",
            "country_code": "US",
            "telephone_number": "619-906-5435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MAYSUN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-02",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "71910",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "91572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.