Jessica Christina Mixco-Cruz

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

100589 Issued in CA

Practice address

480 Alta Rd
San Diego, CA 92179-0001

Phone

(619) 661-6500

NPI assigned

Aug 13, 2018

Reactivated

Oct 12, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Access Psychology Services PCGroup PAC ID 6204155187, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Access Psychology Services PC

  • Psychologist
  • San Diego, CA
  • NPI 1558752931
  Medicare reassignment Care Compare group
• State of California Prison Industry Authority

  • Eyewear Supplier
  • San Diego, CA
  • NPI 1356558001
  NPD (past)

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1568941102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32090 POPPY WAY",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925322510",
            "telephone_number": "626-665-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 ALTA RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921790001",
            "telephone_number": "619-661-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 B St Ste 2870",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921018132",
            "country_code": "US",
            "telephone_number": "619-722-0014",
            "fax_number": "619-327-4174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7800 Parkway Dr",
            "address_purpose": "LOCATION",
            "city": "LA Mesa",
            "state": "CA",
            "postal_code": "919422001",
            "country_code": "US",
            "telephone_number": "619-722-0014",
            "fax_number": "619-327-4174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1340 E Madison Ave",
            "address_purpose": "LOCATION",
            "city": "El Cajon",
            "state": "CA",
            "postal_code": "920218501",
            "country_code": "US",
            "telephone_number": "619-722-0014",
            "fax_number": "619-327-4174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIXCO-CRUZ",
        "first_name": "JESSICA",
        "middle_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "deactivation_date": "2018-10-01",
        "reactivation_date": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "100589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Marie Mitterling, PA-C
• Jessica Lorraine Mitts, BCBA
• Noemi Ana Mitzel, LCSW
• Kristin Danielle Mitzenmacher, OTR/L, MS
• Kayla Am Miura
• Casey D Mixon
• Rena Mixon
• Gary Y Miya, M.D
• Marcus Miyabara
• Sydney Miyabara

• 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 May 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.