Active NPI
Joelle Anne Tonkovich, LCSW
- Clinical Social Worker
- San Diego, CA
National Provider Identifier
1427133628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS21685
- Practice address
- 3990 Old Town Ave
Suite B-100
San Diego, CA 92110-2930 - Phone
- (619) 405-5916
- Fax
- (619) 299-9089
- NPI assigned
- Oct 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS21685 | CA | Primary |
Addresses
Primary practice location
3990 Old Town Ave
Suite B-100
San Diego, CA 92110-2930
Mailing address
3990 Old Town Ave
Suite B-100
San Diego, CA 92110-2930
Phone (619) 405-5916
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LCS21685 | Other | CA | LICENSE |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130311000065 | CA | Practitioner - Clinical Social Worker | 9638324098 | Practice locations: San Diego, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
3990 Old Town Ave
Suite B100
San Diego, CA 92110-2967
Phone (619) 405-5916
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21685 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444176000000",
"number": "1427133628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3990 OLD TOWN AVE",
"address_2": "SUITE B-100",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921102930",
"telephone_number": "619-405-5916",
"fax_number": "619-299-9089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3990 OLD TOWN AVE",
"address_2": "SUITE B-100",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921102930",
"telephone_number": "619-405-5916",
"fax_number": "619-299-9089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TONKOVICH",
"first_name": "JOELLE",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-26",
"last_updated": "2015-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS21685",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "LCS21685",
"state": "CA"
}
],
"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 Oct 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.