Individual provider Active NPI

Danielle Sherie Carr

  • Peer Specialist
  • San Diego, CA
National Provider Identifier
1033702634
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
5400 Kearny Mesa Rd
San Diego, CA 92111-1303
Phone
(619) 717-2363
Fax
(714) 327-0673
NPI assigned
Feb 15, 2021
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Community Health Worker 172V00000X
Peer Specialist 175T00000X CA Primary

Addresses

Primary practice location

5400 Kearny Mesa Rd
San Diego, CA 92111-1303

Mailing address

3186 Airway Ave Ste a
Costa Mesa, CA 92626-4650
Phone (714) 881-0427

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1613347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1033702634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3186 AIRWAY AVE STE A",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264650",
            "telephone_number": "714-881-0427",
            "fax_number": "714-327-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 KEARNY MESA RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111303",
            "telephone_number": "619-717-2363",
            "fax_number": "714-327-0673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "DANIELLE",
        "middle_name": "SHERIE",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2021-02-15",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.