Active NPI
Bianca Plotkin
- Psychologist
- San Diego, CA
National Provider Identifier
1356409197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 34040
- Practice address
- 6640 Three Canyons CT
San Diego, CA 92130-6860 - Phone
- (858) 352-8059
- NPI assigned
- Dec 5, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Psychologist | 103TC0700X | 34040 | CA | |
| Psychologist | 103T00000X | 34040 | CA | Primary |
Addresses
Primary practice location
6640 Three Canyons CT
San Diego, CA 92130-6860
Mailing address
6640 Three Canyons CT
San Diego, CA 92130-6860
Phone (858) 352-8059
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 10, 2024 through Jan 10, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34040 | CA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Research Foundation Inc | Past | Accepting new patients | |
| Community Research Foundation Inc | Clinical | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- San Diego, CA
- NPI 1346463932
-
- Community/Behavioral Health Agency
- San Diego, CA
- NPI 1952328700
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681344000000",
"number": "1356409197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6640 THREE CANYONS CT",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921306860",
"telephone_number": "858-352-8059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6640 THREE CANYONS CT",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921306860",
"telephone_number": "858-352-8059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLOTKIN",
"first_name": "BIANCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2023-04-13",
"certification_date": "2023-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "34040",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "34040",
"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 Apr 13, 2023; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.