Active NPI
Monika Lashelle Bass, AMFT
- Case Management Agency
- San Diego, CA
National Provider Identifier
1497357420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Agency
- Practice address
- 3340 Kemper St Ste 105
San Diego, CA 92110-4907 - Phone
- (619) 523-8121
- NPI assigned
- Nov 13, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | AMFT116920 | CA | |
| Case Management Agency | 251B00000X | Primary |
Addresses
Primary practice location
3340 Kemper St Ste 105
San Diego, CA 92110-4907
Mailing address
3340 Kemper St Ste 105
San Diego, CA 92110-4907
Phone (619) 523-8121
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3737810 | 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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AMFT116920 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730678400000",
"number": "1497357420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3340 KEMPER ST STE 105",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921104907",
"telephone_number": "619-523-8121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3340 KEMPER ST STE 105",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921104907",
"telephone_number": "619-523-8121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASS",
"first_name": "MONIKA",
"middle_name": "LASHELLE",
"name_prefix": "Ms.",
"credential": "AMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-13",
"last_updated": "2024-11-04",
"certification_date": "2024-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "AMFT116920",
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3737810",
"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 Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.