Active NPI
Agnes G Cole
- Clinical Social Worker
- San Diego, CA
National Provider Identifier
1518469899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 129662
- Practice address
- 3491 Kurtz St Ste 150
San Diego, CA 92110-4430 - Phone
- (619) 320-2404
- NPI assigned
- Mar 2, 2018
- Last updated
- Jun 16, 2025
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | NU | ||
| Clinical Social Worker | 1041C0700X | 129662 | CA | Primary |
| Rehabilitation Practitioner | 225400000X | NU | ||
| Case Manager/Care Coordinator | 171M00000X | NU |
Addresses
Primary practice location
3491 Kurtz St Ste 150
San Diego, CA 92110-4430
Mailing address
6884 Hyde Park Dr Unit a
San Diego, CA 92119-2235
Phone (619) 869-3163
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 373781000 | 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 |
|---|---|---|---|
| 129662 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750032000000",
"number": "1518469899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6884 HYDE PARK DR UNIT A",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921192235",
"telephone_number": "619-869-3163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3491 KURTZ ST STE 150",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921104430",
"telephone_number": "619-320-2404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLE",
"first_name": "AGNES",
"middle_name": "G",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-02",
"last_updated": "2025-06-16",
"certification_date": "2025-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "129662",
"primary": true
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "373781000",
"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 Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.