Priscilla Palicki McCullough

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

124192 Issued in CA

Practice address

409 Camino del Rio S Ste 201
San Diego, CA 92108-3505

Phone

(619) 813-9348

NPI assigned

May 4, 2016

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1336595768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 CAMINO DEL RIO S STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083505",
            "telephone_number": "619-813-9348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 CAMINO DEL RIO S STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083505",
            "telephone_number": "619-813-9348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "PRISCILLA",
        "middle_name": "PALICKI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-04",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "124192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Makiko McCullough, OD
• Amanda McCullough
• Deirdre Maureen McCullough, M.D.
• Jocelyn Colleen McCullough, M.A.
• Lynsi McCullough
• Simone Ameneh McCullough
• Mario McCullum
• Brian McCune
• Eric McCune, LVN
• Michael Francis McCune

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.