Joe Anthony Sepulveda, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A113283 Issued in CA

Practice address

4065 3Rd Ave
San Diego, CA 92103-2184

Phone

(619) 255-5120

NPI assigned

May 28, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Health Centers of San Diego IncGroup PAC ID 3476446378, shared by 46 NPIs, 299 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1447281936
  Medicare reassignment NPD
• Momentum for Health

  • Community/Behavioral Health Agency
  • San Jose, CA
  • NPI 1154426807
  Medicare reassignment NPD
• Revive Pathway

  • Substance Use Disorder Rehabilitation Clinic/Center
  • El Cajon, CA
  • NPI 1962117440

  TX

  Medicare reassignment NPD
• Puyallup Tribal Opioid Clinic, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Tacoma, WA
  • NPI 1992582613

  TX

  Medicare reassignment NPD
• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1356178180
  NPD
• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1386689701
  NPD
• Momentum for Health

  • Psychologist
  • San Jose, CA
  • NPI 1760181234
  NPD
• Momentum for Health

  • Mental Illness Community Based Residential Treatment Facility
  • Palo Alto, CA
  • NPI 1881813350
  NPD
• New Life Health Authority

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ukiah, CA
  • NPI 1104435734
  NPD

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

{
    "created_epoch": "1275004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1306165402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 QUARRY ROAD",
            "address_2": "ROOM 2204",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "94025",
            "telephone_number": "650-617-2623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4065 3RD AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032184",
            "telephone_number": "619-255-5120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2204 National Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921133615",
            "country_code": "US",
            "telephone_number": "619-515-2355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 Quarry Road",
            "address_2": "Room 2204",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "94305",
            "country_code": "US",
            "telephone_number": "650-725-2769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEPULVEDA",
        "first_name": "JOE",
        "middle_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A113283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bianca Alina Sepeda, LAC
• Yasmin Sepehrar
• Alexia Sepulveda
• Gabriel Sepulveda, RBT
• Gracey Sepulveda
• Maria de Jesus Sepulveda
• Valeria Sepulveda
• Sequenom Center for Molecular Medicine LLC
• Jenny Seradilla
• Heather Jean Serafin, ACSW

• Psychiatry Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.