Individual provider Active NPI

Pamela Diane Wright, LCSW

  • Clinical Social Worker
  • Chula Vista, CA
National Provider Identifier
1548402092
Registry record updated Mar 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 17367 Issued in CA
Practice address
1124 Bay Blvd
Ste D
Chula Vista, CA 91911-7155
Phone
(619) 420-3620
Fax
(619) 420-8722
NPI assigned
Mar 30, 2009
Last updated
Mar 30, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS 17367 CA Primary

Addresses

Primary practice location

1124 Bay Blvd
Ste D
Chula Vista, CA 91911-7155

Mailing address

1124 Bay Blvd
Ste D
Chula Vista, CA 91911-7155
Phone (619) 420-3620

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
LCS 17367CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238371200000",
    "number": "1548402092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 BAY BLVD",
            "address_2": "STE D",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919117155",
            "telephone_number": "619-420-3620",
            "fax_number": "619-420-8722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 BAY BLVD",
            "address_2": "STE D",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919117155",
            "telephone_number": "619-420-3620",
            "fax_number": "619-420-8722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "PAMELA",
        "middle_name": "DIANE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-30",
        "last_updated": "2009-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 17367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; 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.