Jim Polido Joaquin, SUD COUNSELOR

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

A6231212 Issued in CA

Practice address

3539 College Ave
San Diego, CA 92115-7032

Phone

(619) 818-3788

NPI assigned

Mar 12, 2019

Sex

Male

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1386103018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3539 COLLEGE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921157032",
            "telephone_number": "619-818-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3539 COLLEGE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921157032",
            "telephone_number": "619-818-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOAQUIN",
        "first_name": "JIM",
        "middle_name": "POLIDO",
        "credential": "SUD COUNSELOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-12",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A6231212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanne J. Wendt, PH.D., Clinical Psychologist, Inc.
• Joanne M. Hamilton Psychologist a Professional Corporation
• Carla Mae Joaquin
• Clarence Ray Joaquin, RN
• Clarisa Pulido Joaquin, RN
• Qualita Joaquin, NP
• Julia Jobanputra
• Allison Jobin, PH.D., BCBA-D
• Tara Jobin
• Megan Jobski

• Addiction (Substance Use Disorder) Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.