Active NPI
Mandy Joy Manalastas Felix, LCSW
- Clinical Social Worker
- San Diego, CA
National Provider Identifier
1477952380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 78293
- Practice address
- 286 Euclid Ave Ste 102
San Diego, CA 92114-3611 - Phone
- (619) 266-2111
- Fax
- (619) 266-0496
- NPI assigned
- Aug 15, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Clinical Social Worker | 1041C0700X | 78293 | CA | Primary |
Addresses
Primary practice location
286 Euclid Ave Ste 102
San Diego, CA 92114-3611
Mailing address
286 Euclid Avenue #102
San Diego, CA 92114
Phone (619) 266-2111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RI-L1403041330 | Medicaid | CA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78293 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1477952380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "286 EUCLID AVENUE #102",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92114",
"telephone_number": "619-266-2111",
"fax_number": "619-266-0496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "286 EUCLID AVE STE 102",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921143611",
"telephone_number": "619-266-2111",
"fax_number": "619-266-0496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FELIX",
"first_name": "MANDY",
"middle_name": "JOY MANALASTAS",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-15",
"last_updated": "2022-07-21",
"certification_date": "2020-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "78293",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "RI-L1403041330",
"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 Jul 21, 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.