Active NPI
Sequoia Kermott
- Rehabilitation Practitioner
- San Diego, CA
National Provider Identifier
1285941682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 11622 El Camino Real Ste 100
San Diego, CA 92130-2051 - Phone
- (858) 314-8240
- NPI assigned
- Sep 7, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | CA | Primary | |
| Clinical Psychologist | 103TC0700X | PSB94023983 | CA | |
| Mental Health Counselor | 101YM0800X |
Addresses
Primary practice location
11622 El Camino Real Ste 100
San Diego, CA 92130-2051
Mailing address
PO Box 963
Chula Vista, CA 91912-0963
Phone (858) 432-9744
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSB94023983 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765843200000",
"number": "1285941682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 963",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919120963",
"telephone_number": "858-432-9744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11622 EL CAMINO REAL STE 100",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921302051",
"telephone_number": "858-314-8240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERMOTT",
"first_name": "SEQUOIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-07",
"last_updated": "2025-12-16",
"certification_date": "2025-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": null,
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSB94023983",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.