Individual provider Active NPI

Sasha Michelle Lizardi Luque

  • Professional Counselor
  • San Diego, CA
National Provider Identifier
1174298368
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
17100 Issued in CA
Practice address
591 Camino de la Reina Ste 210
San Diego, CA 92108-3104
Phone
(619) 206-5271
NPI assigned
Aug 10, 2021
Last updated
Aug 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 17100 CA Primary
Rehabilitation Practitioner 225400000X
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

591 Camino de la Reina Ste 210
San Diego, CA 92108-3104

Mailing address

591 Camino de la Reina Ste 210
San Diego, CA 92108-3104

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
17100CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Khachatryan Corporation, Licensed Professional Clinical Counselor CurrentSince Aug 10, 2025 Accepting new patients
Community Research Foundation Inc PastSince Jul 1, 2024 Accepting new patients
Community Research Foundation Inc Case Manager/Care Coordinator PastSince Jul 1, 2024 Accepting new patients

Locations

591 Camino de la Reina
Ste 210
San Diego, CA 92108
Phone (619) 206-5271

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1174298368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 CAMINO DE LA REINA STE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 CAMINO DE LA REINA STE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083104",
            "telephone_number": "619-206-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZARDI LUQUE",
        "first_name": "SASHA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-10",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "17100",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Aug 7, 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.