Individual provider Active NPI

Abby Madariaga

  • Psychiatric/Mental Health Registered Nurse
  • San Diego, CA
National Provider Identifier
1336549633
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
839711 Issued in CA
Practice address
11865 Aspen View Dr
San Diego, CA 92128-5291
Phone
(858) 276-9193
NPI assigned
Aug 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 839711 CA Primary

Addresses

Primary practice location

11865 Aspen View Dr
San Diego, CA 92128-5291

Mailing address

11865 Aspen View Dr
San Diego, CA 92128-5291

Other practice location 1

600 B St
Suite 1570
San Diego, CA 92101-4520
Phone (619) 615-0439

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

LicenseStateTypeSpecialty
839711CAMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1336549633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11865 ASPEN VIEW DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921285291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11865 ASPEN VIEW DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921285291",
            "telephone_number": "858-276-9193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 B St",
            "address_2": "Suite 1570",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921014520",
            "country_code": "US",
            "telephone_number": "619-615-0439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADARIAGA",
        "first_name": "ABBY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-25",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "839711",
            "primary": true
        }
    ],
    "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 Feb 14, 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.

Verify at the official NPI Registry.