Fabian Escobedo Jr., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

109034 Issued in CA

Practice address

3255 Wing St
San Diego, CA 92110-4638

Phone

(619) 980-5260

NPI assigned

Jun 6, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• San Diego Youth Services

  • Case Management Agency
  • San Diego, CA
  • NPI 1629379581
  NPD (past)
• San Diego Youth Services

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1689195398
  NPD (past)

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1245899962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3255 WING ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104638",
            "telephone_number": "619-980-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3255 WING ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104638",
            "telephone_number": "619-980-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCOBEDO",
        "first_name": "FABIAN",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-06",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "109034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolina Escobedo Sanchez
• Adilene Escobedo
• Alicia Escobedo
• Angel de Luna Escobedo
• Eva Bernadette Escobedo, EVA
• Gladys Adamaris Escobedo
• Jorge Escobedo
• Jose Escobedo
• Marisol Escobedo
• Oscar Solis Escobedo Jr., MD

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.