Individual provider Active NPI

Sasha Marie Medoff Jay, ASW

  • Mental Health Counselor
  • San Diego, CA
National Provider Identifier
1497395073
Registry record updated May 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
ASW93062 Issued in CA
Practice address
3731 6TH Ave Ste 100
San Diego, CA 92103-4383
Phone
(619) 278-0884
NPI assigned
Jan 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Mental Health Counselor 101YM0800X ASW93062 CA Primary

Addresses

Primary practice location

3731 6TH Ave Ste 100
San Diego, CA 92103-4383

Mailing address

3002 Armstrong St
San Diego, CA 92111-5702
Phone (858) 633-4106

Other practice location 1

734 10th Ave
San Diego, CA 92101-6502
Phone (619) 239-4663

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

LicenseStateTypeSpecialty
ASW93062CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Research Foundation Inc PastSince Jan 1, 2020 Accepting new patients
Community Research Foundation Inc PastSince Jan 1, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619913600000",
    "number": "1497395073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3002 ARMSTRONG ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921115702",
            "telephone_number": "858-633-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3731 6TH AVE STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034383",
            "telephone_number": "619-278-0884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "734 10th Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921016502",
            "country_code": "US",
            "telephone_number": "619-239-4663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAY",
        "first_name": "SASHA",
        "middle_name": "MARIE MEDOFF",
        "credential": "ASW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-10",
        "last_updated": "2021-05-02",
        "certification_date": "2021-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW93062",
            "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 2, 2021; 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.