Individual provider Active NPI

Mariam Kiara Lowe

  • Clinical Social Worker
  • Chula Vista, CA
National Provider Identifier
1053934059
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
129360 Issued in CA
Practice address
1741 Eastlake Pkwy Ste 102
PMB #196
Chula Vista, CA 91915-2032
Phone
(619) 786-4559
NPI assigned
May 26, 2020
Reactivated
Jun 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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 129360 CA Primary

Addresses

Primary practice location

1741 Eastlake Pkwy Ste 102
PMB #196
Chula Vista, CA 91915-2032

Mailing address

1741 Eastlake Pkwy Ste 102
PMB #196
Chula Vista, CA 91915-2032

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
I20251120004362 CA Practitioner - Clinical Social Worker 3779075346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1741 Eastlake Pkwy
Suite 102 PMB 196
Chula Vista, CA 91915-2032

3127 Sweetwater Springs Blvd Apt
Suite 97
Spring Valley, CA 91978-1532

500 Westover Dr
Sanford, NC 27330-8941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca Clinical CurrentSince Nov 8, 2025 Accepting new patients
City of Fremont CurrentSince Dec 22, 2024 Accepting new patients
Community Research Foundation Inc PastSince Dec 1, 2021 Accepting new patients
Community Research Foundation Inc Clinical PastSince Dec 1, 2021 Accepting new patients

Locations

39155 Liberty St
Ste A110
Fremont, CA 94538
Phone (510) 574-2000

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 4

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": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1053934059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 EASTLAKE PKWY STE 102",
            "address_2": "PMB #196",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919152032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 EASTLAKE PKWY STE 102",
            "address_2": "PMB #196",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919152032",
            "telephone_number": "619-786-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWE",
        "first_name": "MARIAM",
        "middle_name": "KIARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-26",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "deactivation_date": "2021-05-26",
        "reactivation_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "129360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.