Active NPI
Phyllis Anne Carlson
- Clinical Social Worker
- El Cajon, CA
National Provider Identifier
1487028700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW16283
- Practice address
- 389 N Magnolia Ave
El Cajon, CA 92020-3977 - Phone
- (619) 401-3737
- Fax
- (619) 401-3741
- NPI assigned
- Nov 24, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW16283 | CA | Primary |
Addresses
Primary practice location
389 N Magnolia Ave
El Cajon, CA 92020-3977
Mailing address
389 N Magnolia Ave
El Cajon, CA 92020-3977
Phone (619) 401-3737
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 |
|---|---|---|---|
| LCSW16283 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448323200000",
"number": "1487028700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "389 N MAGNOLIA AVE",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920203977",
"telephone_number": "619-401-3737",
"fax_number": "619-401-3741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "389 N MAGNOLIA AVE",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920203977",
"telephone_number": "619-401-3737",
"fax_number": "619-401-3741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "PHYLLIS",
"middle_name": "ANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-24",
"last_updated": "2015-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW16283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.