Individual provider Active NPI

Ana Karen Guaderrama, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1164839908
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1222562 Issued in CA
Practice address
3131 Camino del Rio N Ste 700
San Diego, CA 92108-5708
Phone
(619) 235-0120
NPI assigned
Jul 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 1222562 CA Primary

Addresses

Primary practice location

3131 Camino del Rio N Ste 700
San Diego, CA 92108-5708

Mailing address

3131 Camino del Rio N Ste 700
San Diego, CA 92108-5708
Phone (619) 235-0120

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
1222562CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1164839908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 CAMINO DEL RIO N STE 700",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085708",
            "telephone_number": "619-235-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 CAMINO DEL RIO N STE 700",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085708",
            "telephone_number": "619-235-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUADERRAMA",
        "first_name": "ANA",
        "middle_name": "KAREN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "1222562",
            "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 Nov 25, 2025; 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.