Jean Maire Ertl, LCSW, ACSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS13029 Issued in CA

Practice address

8810 Rio San Diego Dr
San Diego, CA 92108-1622

Phone

(619) 400-5181

Fax

(619) 400-5154

NPI assigned

Jul 31, 2006

Sex

Female

Sole proprietor

Yes

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407862436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4852 LILA DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921151910",
            "telephone_number": "619-286-2687",
            "fax_number": "619-286-2687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8810 RIO SAN DIEGO DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081622",
            "telephone_number": "619-400-5181",
            "fax_number": "619-400-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERTL",
        "first_name": "JEAN",
        "middle_name": "MAIRE",
        "name_prefix": "Mrs.",
        "credential": "LCSW, ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS13029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martyna Anna Erskine, FNP
• Ayse Ertas
• Michelle Ertel
• Adrienne Ertl, M.D.
• Charles Clark Ertl, PH.D.
• Sean Tyson Erts, RADT
• Judith A. Ervice, LMFT
• Johnathon L Ervin
• Laila Ervin
• Morty Morris Ervin Jr., IDC

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, 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 Jul 8, 2007; 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.