Individual provider Active NPI

Andrea Pape Rose, L.C.S.W.

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1447704598
Registry record updated May 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
3411 3Rd Ave
San Diego, CA 92103-4906
Phone
(619) 993-3883
Fax
(619) 330-7124
NPI assigned
Aug 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2022

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 CA Primary

Addresses

Primary practice location

3411 3Rd Ave
San Diego, CA 92103-4906

Mailing address

4346 Hill St
San Diego, CA 92107-4117
Phone (619) 417-8811

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
I20181017000774 CA Practitioner - Clinical Social Worker 5193077386 Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3233 3Rd Ave
San Diego, CA 92103-5615
Phone (619) 417-8811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71136CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Andrea P. Rose, Licensed Clinical Social Worker, Inc. Clinical CurrentSince May 8, 2022 Accepting new patients

Locations

3411 3rd Ave
San Diego, CA 92103
Phone (619) 298-6610

Organizations & group practices 1

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": "1470441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1447704598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4346 HILL ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921074117",
            "telephone_number": "619-417-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 3RD AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034906",
            "telephone_number": "619-993-3883",
            "fax_number": "619-330-7124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "ANDREA",
        "middle_name": "PAPE",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-06",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.