Individual provider Active NPI

Ian Stravinsky, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1396152013
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
84393 Issued in CA
Practice address
7850 Vista Hill Ave
San Diego, CA 92123-2717
Phone
(858) 465-6284
NPI assigned
Jul 15, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 84393 CA Primary

Addresses

Primary practice location

7850 Vista Hill Ave
San Diego, CA 92123-2717

Mailing address

4231 Balboa Ave # 3074
San Diego, CA 92117-5504
Phone (858) 465-6284

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

LicenseStateTypeSpecialty
84393CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1396152013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4231 BALBOA AVE # 3074",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175504",
            "telephone_number": "858-465-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7850 VISTA HILL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232717",
            "telephone_number": "858-465-6284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRAVINSKY",
        "first_name": "IAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "84393",
            "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 Oct 15, 2020; 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.