Individual provider Active NPI

Samantha Hall

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1295330090
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
100069 Issued in CA
Practice address
3665 Kearny Villa Rd Ste 101
San Diego, CA 92123-1954
Phone
(858) 966-5832
NPI assigned
Dec 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 100069 CA Primary

Addresses

Primary practice location

3665 Kearny Villa Rd Ste 101
San Diego, CA 92123-1954

Mailing address

3665 Kearny Villa Rd Ste 101
San Diego, CA 92123-1954
Phone (858) 966-5832

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL shall5@rchsd.org
CONNECT URL shall5@rchsd.org

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

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1295330090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3665 KEARNY VILLA RD STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231954",
            "telephone_number": "858-966-5832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3665 KEARNY VILLA RD STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231954",
            "telephone_number": "858-966-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-01",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "100069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "shall5@rchsd.org",
            "affiliation": "N",
            "address_1": "3665 Kearny Villa Rd Ste 101",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921231954",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "shall5@rchsd.org",
            "affiliation": "N",
            "address_1": "3665 Kearny Villa Rd Ste 101",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921231954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Oct 10, 2023; 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.