Organization Active NPI

Andrea P. Rose, Licensed Clinical Social Worker, Inc.

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1457097099
Registry record updated May 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
ANDREA P. ROSE, LICENSED CLINICAL SOCIAL WORKER, INC.
Practice address
3411 3Rd Ave
San Diego, CA 92103-4906
Phone
(619) 993-3883
Fax
(619) 330-7124
NPI assigned
May 6, 2022
Organization subpart
No

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

Authorized official

Name
Andrea P. Rose, LCSWNPI 1447704598
Title
LCSW/President
Phone
(619) 993-3883

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 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

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651795200000",
    "number": "1457097099",
    "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": {
        "organization_name": "ANDREA P. ROSE, LICENSED CLINICAL SOCIAL WORKER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-06",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "LCSW/PRESIDENT",
        "authorized_official_telephone_number": "619-993-3883",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "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 May 6, 2022; 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.