Individual provider Active NPI

Adriana Guevara

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1194925842
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
26974 Issued in CA
Practice address
6749 El Banquero PL
San Diego, CA 92119-1129
Phone
(831) 332-7553
NPI assigned
Jul 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 26974 CA Primary
Clinical Social Worker 1041C0700X 18692 CA

Addresses

Primary practice location

6749 El Banquero PL
San Diego, CA 92119-1129

Mailing address

6749 El Banquero PL
San Diego, CA 92119-1129
Phone (831) 325-2807

Other practice location 1

157 Van Ness Ave Ste 2
Santa Cruz, CA 95060-4200
Phone (831) 325-2807

Other identifiers 3

IdentifierTypeStateIssuer
1194925842MedicaidCA
ZZZ92069ZOtherCASANTA CRUZ COUNTY MEDICARE GROUP NUMBER
ZZZ91892ZOtherCASANTA CRUZ COUNTY MEDICARE GROUP NUMBER

Other names 1

  • Adriana Guevara Professional name

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
I20110815000526 CA Practitioner - Clinical Social Worker 8426227109 Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3990 Old Town Ave
Suite B100
San Diego, CA 92110-2967
Phone (831) 359-7672

7290 Navajo Rd
Suite 109
San Diego, CA 92119-1631
Phone (619) 356-8387

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18692CAMDClinical Social Worker
26974CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Cruz Past Accepting new patients

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": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1194925842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6749 EL BANQUERO PL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921191129",
            "telephone_number": "831-325-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6749 EL BANQUERO PL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921191129",
            "telephone_number": "831-332-7553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "157 Van Ness Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Santa Cruz",
            "state": "CA",
            "postal_code": "950604200",
            "country_code": "US",
            "telephone_number": "831-325-2807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUEVARA",
        "first_name": "ADRIANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "26974",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "18692",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194925842",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MEDICARE GROUP NUMBER",
            "identifier": "ZZZ92069Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MEDICARE GROUP NUMBER",
            "identifier": "ZZZ91892Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADRIANA",
            "last_name": "GUEVARA",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.