Active NPI
Marlene Alice Wendel, LCSW
- Clinical Social Worker
- San Diego, CA
National Provider Identifier
1457026379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW87630
- Practice address
- 4729 34TH St Unit 6
San Diego, CA 92116-1857 - Phone
- (858) 205-4308
- NPI assigned
- Aug 12, 2021
- 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 | LCSW87630 | CA | Primary |
Addresses
Primary practice location
4729 34TH St Unit 6
San Diego, CA 92116-1857
Mailing address
2525 Camino del Rio S Ste 310
San Diego, CA 92108-3784
Phone (619) 858-4035
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 1, 2023 through Dec 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW87630 | CA | MD | Clinical Social Worker |
| 87630 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628726400000",
"number": "1457026379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2525 CAMINO DEL RIO S STE 310",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921083784",
"telephone_number": "619-858-4035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4729 34TH ST UNIT 6",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921161857",
"telephone_number": "858-205-4308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENDEL",
"first_name": "MARLENE",
"middle_name": "ALICE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-12",
"last_updated": "2021-08-12",
"certification_date": "2021-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW87630",
"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 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.