Individual provider Active NPI

Yezenia Arali Vargas

  • Clinical Social Worker
  • Alpine, CA
National Provider Identifier
1174232680
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
108093 Issued in CA
Practice address
2271 Alpine Blvd Ste a
Alpine, CA 91901-1101
Phone
(626) 991-5592
NPI assigned
Nov 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 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 108093 CA Primary

Addresses

Primary practice location

2271 Alpine Blvd Ste a
Alpine, CA 91901-1101

Mailing address

4075 Park Blvd Ste 102-378
San Diego, CA 92103-2670
Phone (626) 991-5592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230313001352 CA Practitioner - Clinical Social Worker 6305210428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2271 Alpine Blvd
Suite a
Alpine, CA 91901-1101
Phone (619) 448-1216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
108093CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fusion Care Group, a Psychological Professional Corporation CurrentSince Mar 1, 2023 Accepting new patients

Locations

2271 Alpine Blvd
Ste A
Alpine, CA 91901
Phone (619) 289-7322

Organizations & group practices 1

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": "1669161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1174232680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4075 PARK BLVD STE 102-378",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032670",
            "telephone_number": "626-991-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2271 ALPINE BLVD STE A",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919011101",
            "telephone_number": "626-991-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "YEZENIA",
        "middle_name": "ARALI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-23",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "108093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpine, CA

Sources for this page

Verify at the official NPI Registry.