Sam Ezra Potter, ASW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

124719 Issued in CA

Practice address

251 Landis Ave
Chula Vista, CA 91910-2628

Phone

(619) 515-2500

NPI assigned

Jan 30, 2020

Sex

Unspecified or another gender identity

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

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1396376109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 LANDIS AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102628",
            "telephone_number": "619-515-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "SAM",
        "middle_name": "EZRA",
        "credential": "ASW",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2020-01-30",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "124719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mike Porter
• Raquel Portillo
• Jessica Lynn Ports
• Caitlynn Danae Posada
• Fernando Esteban Postigo, D.O.
• Sandra L Potter
• Pourang Kamali MD Inc
• Ute Powell, RN, PHN
• Amanda Powers, PSYD
• Ravindra Prabhu, M.D.

• Clinical Social Worker in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.

Verify at the official NPI Registry.