Individual provider Active NPI

Elisa Christina Tijerina, LCSW

  • Clinical Social Worker
  • San Antonio, TX
National Provider Identifier
1083375737
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
64816 Issued in TX
Practice address
4811 Fredericksburg Rd
San Antonio, TX 78229-3661
Phone
(210) 977-0261
NPI assigned
Jan 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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 64816 TX Primary

Addresses

Primary practice location

4811 Fredericksburg Rd
San Antonio, TX 78229-3661

Mailing address

4811 Fredericksburg Rd Ste B
San Antonio, TX 78229-3751
Phone (210) 977-0261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220922003296 TX Practitioner - Clinical Social Worker 3375928666 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64816TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
4Davidcantu, LLC Clinical CurrentSince Aug 1, 2022 Accepting new patients
Comfort Counseling 4 U LLC CurrentSince Jun 11, 2023 Accepting new patients

Locations

4811 Fredericksburg Rd
Ste B
San Antonio, TX 78229
Phone (210) 789-4605

4811 Fredericksburg Rd
San Antonio, TX 78229
Phone (210) 977-0261

Organizations & group practices 2

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": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1083375737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4811 FREDERICKSBURG RD STE B",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293751",
            "telephone_number": "210-977-0261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4811 FREDERICKSBURG RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293661",
            "telephone_number": "210-977-0261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIJERINA",
        "first_name": "ELISA",
        "middle_name": "CHRISTINA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "64816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.