Individual provider Active NPI

Kaixin Zhang

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1184088239
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
10815 Rancho Bernardo Rd Ste 370
San Diego, CA 92127-5707
Phone
(888) 588-8995
NPI assigned
Apr 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 95709 CA
Clinical Social Worker 1041C0700X Primary
Counselor 101Y00000X

Addresses

Primary practice location

10815 Rancho Bernardo Rd Ste 370
San Diego, CA 92127-5707

Mailing address

PO Box 530077
Atlanta, GA 30353-0077

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
I20220420001301 CA Practitioner - Clinical Social Worker 4183011224 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95709CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Union of Pan Asian Communities CurrentSince Dec 17, 2021 Accepting new patients
Sud Specialty Group - Ca Clinical CurrentSince May 1, 2025 Accepting new patients
Union of Pan Asian Communities Current Accepting new patients
Union of Pan Asian Communities CurrentSince Dec 17, 2021 Accepting new patients
Foresight Mental Health Counselor PastSince Nov 19, 2023 Accepting new patients
Union of Pan Asian Communities Past Accepting new patients

Locations

1031 25th St
San Diego, CA 92102
Phone (619) 232-6454

5348 University Ave
Ste 101
San Diego, CA 92105
Phone (619) 229-2999

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Interoperability endpoints

  • Direct secure messaging: kaixin.zhang.1@25119.direct.athenahealth.com

Organizations & group practices 6

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": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1184088239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530077",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10815 RANCHO BERNARDO RD STE 370",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275707",
            "telephone_number": "888-588-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHANG",
        "first_name": "KAIXIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-05",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "95709",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.