Active NPI
Odon Joseph Hidalgo, LCSW,LPC,LMFT
- Clinical Social Worker
- San Diego, CA
National Provider Identifier
1083924864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 02851
- Practice address
- 4715 Viewridge Ave
Suite 230
San Diego, CA 92123-1658 - Phone
- (800) 257-8715
- Fax
- (858) 874-8212
- NPI assigned
- Oct 14, 2010
- Sex
- Male
- Sole proprietor
- No
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 | 02851 | TX | Primary |
Addresses
Primary practice location
4715 Viewridge Ave
Suite 230
San Diego, CA 92123-1658
Mailing address
4715 Viewridge Ave
Suite 230
San Diego, CA 92123-1658
Phone (800) 257-8715
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
| License | State | Type | Specialty |
|---|---|---|---|
| 02851 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287014400000",
"number": "1083924864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4715 VIEWRIDGE AVE",
"address_2": "SUITE 230",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231658",
"telephone_number": "800-257-8715",
"fax_number": "858-874-8212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4715 VIEWRIDGE AVE",
"address_2": "SUITE 230",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231658",
"telephone_number": "800-257-8715",
"fax_number": "858-874-8212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIDALGO",
"first_name": "ODON",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "LCSW,LPC,LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-14",
"last_updated": "2010-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "02851",
"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 Oct 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.