Active NPI
Adriana Ezernack
- Social Worker
- Chula Vista, CA
National Provider Identifier
1407634090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ASW112126
- Practice address
- 1800 Maxwell Rd
Chula Vista, CA 91911-6158 - Phone
- (833) 503-5910
- NPI assigned
- Sep 15, 2023
- Last updated
- Jul 18, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | ASW112126 | CA | Primary |
Addresses
Primary practice location
1800 Maxwell Rd
Chula Vista, CA 91911-6158
Mailing address
1800 Maxwell Rd
Chula Vista, CA 91911-6158
Phone (858) 294-9714
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
| License | State | Type | Specialty |
|---|---|---|---|
| ASW112126 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721260800000",
"number": "1407634090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 MAXWELL RD",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919116158",
"telephone_number": "858-294-9714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 MAXWELL RD",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919116158",
"telephone_number": "833-503-5910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZERNACK",
"first_name": "ADRIANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-15",
"last_updated": "2024-07-18",
"certification_date": "2023-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "ASW112126",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chula Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.