Individual provider Active NPI

Holly Elizabeth Bates, LCSW

  • Clinical Social Worker
  • Chula Vista, CA
National Provider Identifier
1407147390
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
72955 Issued in CA
Practice address
2300 Boswell Rd Ste 275
Chula Vista, CA 91914-3557
Phone
(858) 279-1223
NPI assigned
Apr 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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 72955 CA Primary

Addresses

Primary practice location

2300 Boswell Rd Ste 275
Chula Vista, CA 91914-3557

Mailing address

2300 Boswell Rd Ste 275
Chula Vista, CA 91914-3557
Phone (858) 279-1223

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
I20171002003115 CA Practitioner - Clinical Social Worker 6709151772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

2300 Boswell Rd
Suite 275
Chula Vista, CA 91914-3557
Phone (858) 279-1223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
72955CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Psycare Inc CurrentSince Aug 31, 2017 Accepting new patients
Pacific Coast Psychiatric Associates Inc CurrentSince Sep 13, 2023 Accepting new patients

Locations

2300 Boswell Rd
Ste 275
Chula Vista, CA 91914
Phone (585) 898-0612

4550 Kearny Villa Rd
Ste 116
San Diego, CA 92123
Phone (619) 279-1223

4540 Kearny Villa Rd
Ste 103
San Diego, CA 92123
Phone (858) 259-1223

Interoperability endpoints

  • Direct secure messaging: psycareassociates.hollybates@143255.advancedmd-direct.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1407147390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 BOSWELL RD STE 275",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143557",
            "telephone_number": "858-279-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 BOSWELL RD STE 275",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143557",
            "telephone_number": "858-279-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATES",
        "first_name": "HOLLY",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-26",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "72955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.