Active NPI
Cassandra Detgen
- Mental Health Counselor
- San Diego, CA
National Provider Identifier
1457973455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 7432
- Practice address
- 5252 Orange Ave Unit 125
San Diego, CA 92115-6029 - Phone
- (330) 204-3256
- NPI assigned
- May 12, 2020
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 7432 | CA | Primary |
Addresses
Primary practice location
5252 Orange Ave Unit 125
San Diego, CA 92115-6029
Mailing address
5252 Orange Ave Unit 125
San Diego, CA 92115-6029
Phone (330) 204-3256
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | cdetgen@ucsd.edu |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7432 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589241600000",
"number": "1457973455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5252 ORANGE AVE UNIT 125",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921156029",
"telephone_number": "330-204-3256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5252 ORANGE AVE UNIT 125",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921156029",
"telephone_number": "330-204-3256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETGEN",
"first_name": "CASSANDRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-12",
"last_updated": "2020-05-12",
"certification_date": "2020-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "7432",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "cdetgen@ucsd.edu",
"affiliation": "N",
"address_1": "5252 Orange Ave Unit 125",
"city": "San Diego",
"state": "CA",
"country_code": "US",
"postal_code": "921156029",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.