Individual provider Active NPI

Kristy Buterbaugh, LCSW

  • Clinical Social Worker
  • Escondido, CA
National Provider Identifier
1346615838
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW65477 Issued in CA
Practice address
1341 N Escondido Blvd
Escondido, CA 92026-2507
Phone
(760) 317-9119
NPI assigned
Dec 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X MCAB1110030259 CA
Clinical Social Worker 1041C0700X LCSW65477 CA Primary

Addresses

Primary practice location

1341 N Escondido Blvd
Escondido, CA 92026-2507

Mailing address

1341 N Escondido Blvd
Escondido, CA 92026-2507
Phone (760) 317-9119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200630002394 CA Practitioner - Clinical Social Worker 5991128498 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MCAB1110030259CAMDAddiction (Substance Use Disorder) Counselor
LCSW65477CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc. CurrentSince May 21, 2020 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince May 21, 2020 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients

Locations

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1346615838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 N ESCONDIDO BLVD",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920262507",
            "telephone_number": "760-317-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 N ESCONDIDO BLVD",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920262507",
            "telephone_number": "760-317-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTERBAUGH",
        "first_name": "KRISTY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-09",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "MCAB1110030259",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW65477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.