Active NPI
Eduardo Carrasco, MSW, LCSW
- Clinical Social Worker
- San Diego, CA
National Provider Identifier
1043398910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS 24493
- Practice address
- 8810 Rio San Diego Dr
Ms# 122HZ
San Diego, CA 92108-1698 - Phone
- (619) 400-5157
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS 24493 | CA | Primary |
Addresses
Primary practice location
8810 Rio San Diego Dr
Ms# 122HZ
San Diego, CA 92108-1698
Mailing address
8810 Rio San Diego Dr
Ms# 122HZ
San Diego, CA 92108-1698
Phone (619) 400-5157
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LCS 24493 | Other | CA | CALIFORNIA BOARD OF BEHAVIORAL SCIENCES |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS 24493 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299024000000",
"number": "1043398910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8810 RIO SAN DIEGO DR",
"address_2": "MS# 122HZ",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921081698",
"telephone_number": "619-400-5157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8810 RIO SAN DIEGO DR",
"address_2": "MS# 122HZ",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921081698",
"telephone_number": "619-400-5157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRASCO",
"first_name": "EDUARDO",
"name_prefix": "Mr.",
"credential": "MSW, LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2011-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS 24493",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA BOARD OF BEHAVIORAL SCIENCES",
"identifier": "LCS 24493",
"state": "CA"
}
],
"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 Mar 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.