Individual provider Active NPI

Michael Patton, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1184756702
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
18244 Issued in CA
Practice address
1501 Imperial Ave
San Diego, CA 92103
Phone
(619) 645-6702
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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 18244 CA Primary

Addresses

Primary practice location

1501 Imperial Ave
San Diego, CA 92103

Mailing address

1501 Imperial Ave
San Diego, CA 92101-7638
Phone (619) 645-6702

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
I20230911001102 CA Order and Referring Only - Clinical Social Worker 6305917725

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371513600000",
    "number": "1184756702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 IMPERIAL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921017638",
            "telephone_number": "619-645-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 IMPERIAL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92103",
            "telephone_number": "619-645-6702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTON",
        "first_name": "MICHAEL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2013-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "18244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.