Individual provider Active NPI

Sadie Hellstrom

  • Clinical Social Worker
  • Vista, CA
National Provider Identifier
1104762954
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
122892 Issued in CA
Practice address
200 Michigan Ave
Vista, CA 92084-5424
Phone
(760) 726-4900
NPI assigned
Apr 24, 2026
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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 122892 CA Primary

Addresses

Primary practice location

200 Michigan Ave
Vista, CA 92084-5424

Mailing address

200 Michigan Ave
Vista, CA 92084-5424

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

LicenseStateTypeSpecialty
122892CAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1776988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1104762954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MICHIGAN AVE",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920845424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MICHIGAN AVE",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920845424",
            "telephone_number": "760-726-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLSTROM",
        "first_name": "SADIE",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2026-04-24",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "122892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; 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.