Katelyn Jeanne Ouimet, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

97853 Issued in CA

Practice address

4055 Park Blvd
San Diego, CA 92103-2619

Phone

(860) 681-5383

NPI assigned

Jan 13, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1518556604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1286 UNIVERSITY AVE # 736",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033312",
            "telephone_number": "860-681-5383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 PARK BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032619",
            "telephone_number": "860-681-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUIMET",
        "first_name": "KATELYN",
        "middle_name": "JEANNE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "122488",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "97853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICSW",
            "identifier": "122488",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bashar Oudah, MD
• Patricia Ouellette Lague, RD
• Natalie Ouellette, MD
• Nicole Ouellette
• Danielle Elyse Ouidiani, BCBA
• Sean Paul Ouimet, MD
• Sydney Oukrop
• Shaelinh Oum
• Linsonyda Ourng
• Aliyah Ouro-Akondo

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.