Mariana Da Costa Teal, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

89561 Issued in CA

Practice address

9920 Pacific Heights Blvd Ste 150
San Diego, CA 92121-4361

Phone

(650) 434-2563

NPI assigned

Sep 15, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1255053252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9920 PACIFIC HEIGHTS BLVD STE 150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214361",
            "telephone_number": "650-434-2563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9920 PACIFIC HEIGHTS BLVD STE 150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214361",
            "telephone_number": "650-434-2563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEAL",
        "first_name": "MARIANA",
        "middle_name": "DA COSTA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "89561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mariana@mindbodypsychology.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9920 Pacific Heights Blvd Ste 150",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921214361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Judi A Teaze
• Ali Tebbs, DPT, PT

• 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 Oct 12, 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.