Individual provider Active NPI

Erica Kardonsky, LCSW

  • Mental Health Counselor
  • San Diego, CA
National Provider Identifier
1164826947
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
76063 Issued in CA
Practice address
9815 Carroll Canyon Rd Ste 101
San Diego, CA 92131-1123
Phone
(805) 234-5714
Fax
(858) 408-7141
NPI assigned
Oct 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 76063 CA
Mental Health Counselor 101YM0800X 76063 CA Primary

Addresses

Primary practice location

9815 Carroll Canyon Rd Ste 101
San Diego, CA 92131-1123

Mailing address

12061 Tivoli Park Row Unit 1
San Diego, CA 92128-4383
Phone (805) 234-5714

Other practice location 1

1012 Main St
#101
Ramona, CA 92065-2170
Phone (760) 788-9724

Other practice location 2

9666 Businesspark Ave Ste 201
San Diego, CA 92131-1646
Phone (805) 234-5714

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
76063CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1164826947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12061 TIVOLI PARK ROW UNIT 1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284383",
            "telephone_number": "805-234-5714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9815 CARROLL CANYON RD STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311123",
            "telephone_number": "805-234-5714",
            "fax_number": "858-408-7141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1012 Main St",
            "address_2": "#101",
            "address_purpose": "LOCATION",
            "city": "Ramona",
            "state": "CA",
            "postal_code": "920652170",
            "country_code": "US",
            "telephone_number": "760-788-9724",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9666 Businesspark Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921311646",
            "country_code": "US",
            "telephone_number": "805-234-5714",
            "fax_number": "858-408-7141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KARDONSKY",
        "first_name": "ERICA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-22",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "76063",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "76063",
            "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 Mar 28, 2019; 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.