Demetrius Anderson, ASW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

ASW93778 Issued in CA

Practice address

Telecare Corporation Ihot
1660 Hotel Circle North, Suite 101
San Deigo, CA 92108

Phone

(619) 961-2120

NPI assigned

Mar 17, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1285260737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 MIDDLE FORK PL",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919142623",
            "telephone_number": "614-571-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TELECARE CORPORATION IHOT",
            "address_2": "1660 HOTEL CIRCLE NORTH, SUITE 101",
            "city": "SAN DEIGO",
            "state": "CA",
            "postal_code": "92108",
            "telephone_number": "619-961-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DEMETRIUS",
        "name_prefix": "Mr.",
        "credential": "ASW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-17",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW93778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Telecare",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "Telecare Corporation IHOT",
            "address_2": "1660 Hotel Circle North, Suite 101",
            "city": "San Deigo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "92108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Catherine Rita Farnam, RN, APRN
• Jeffrey D Hall
• Anthony Kahraan Hargrove
• Deborah D. Landis, RDH
• United MRI Network Inc.

• All providers in San Deigo, CA
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; 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.