Active NPI
Theresa Blain
- Clinical Social Worker
- El Cajon, CA
National Provider Identifier
1346001484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ASW112487
- Practice address
- 12190 Cuyamaca College Dr E Unit 1204
El Cajon, CA 92019-4356 - Phone
- (703) 386-6283
- NPI assigned
- Jan 16, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ASW112487 | CA | Primary |
Addresses
Primary practice location
12190 Cuyamaca College Dr E Unit 1204
El Cajon, CA 92019-4356
Mailing address
4221 Wilshire Blvd Ste 230
Los Angeles, CA 90010-3554
Phone (213) 505-4307
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 |
|---|---|---|---|
| ASW112487 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705363200000",
"number": "1346001484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4221 WILSHIRE BLVD STE 230",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900103554",
"telephone_number": "213-505-4307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12190 CUYAMACA COLLEGE DR E UNIT 1204",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920194356",
"telephone_number": "703-386-6283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAIN",
"first_name": "THERESA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-16",
"last_updated": "2024-01-16",
"certification_date": "2024-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW112487",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.