Individual provider Active NPI

Tamera Martino Fleck, LCSW

  • Clinical Social Worker
  • San Marcos, CA
National Provider Identifier
1053649681
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS23477 Issued in CA
Practice address
1244 San Elijo Rd N
San Marcos, CA 92078-1086
Phone
(760) 517-6257
Fax
(760) 593-2699
NPI assigned
Nov 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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 LCS23477 CA Primary

Addresses

Primary practice location

1244 San Elijo Rd N
San Marcos, CA 92078-1086

Mailing address

1501 San Elijo Rd S
#104-117
San Marcos, CA 92078-2047
Phone (760) 517-6257

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS23477CAMDClinical Social Worker
23477CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Centers at San Diego, Inc. Med GRP Clinical Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 1

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": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1053649681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 SAN ELIJO RD S",
            "address_2": "#104-117",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782047",
            "telephone_number": "760-517-6257",
            "fax_number": "760-593-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 SAN ELIJO RD N",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920781086",
            "telephone_number": "760-517-6257",
            "fax_number": "760-593-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLECK",
        "first_name": "TAMERA",
        "middle_name": "MARTINO",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-19",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS23477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.