Individual provider Active NPI

Edgar Sortigosa Capacio, AOD COUNSELOR

  • Addiction (Substance Use Disorder) Counselor
  • San Diego, CA
National Provider Identifier
1417178757
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
1031 25TH St
San Diego, CA 92102-2102
Phone
(619) 232-6454
Fax
(619) 235-4607
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

1031 25TH St
San Diego, CA 92102-2102

Mailing address

1463 Paseo Aurora
San Diego, CA 92154-4867
Phone (619) 946-4226

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

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1417178757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1463 PASEO AURORA",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921544867",
            "telephone_number": "619-946-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 25TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921022102",
            "telephone_number": "619-232-6454",
            "fax_number": "619-235-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPACIO",
        "first_name": "EDGAR",
        "middle_name": "SORTIGOSA",
        "name_prefix": "Mr.",
        "credential": "AOD COUNSELOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "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 Aug 1, 2013; 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.