Individual provider Active NPI

Ryoko Muta, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1578810107
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW80617 Issued in CA
Practice address
1250 Morena Blvd FL 1
San Diego, CA 92110-3815
Phone
(619) 692-8750
NPI assigned
Aug 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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 LCSW80617 CA Primary

Addresses

Primary practice location

1250 Morena Blvd FL 1
San Diego, CA 92110-3815

Mailing address

1250 Morena Blvd FL 1
San Diego, CA 92110-3815
Phone (619) 692-8750

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260313003383 CA Order and Referring Only - Clinical Social Worker 0840773180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW80617CAMDClinical Social Worker
80617CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Diego CurrentSince Dec 14, 2025 Accepting new patients

Locations

1250 Morena Blvd
Fl 1
San Diego, CA 92110
Phone (619) 692-8750

Organizations & group practices 1

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": "1344902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1578810107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 MORENA BLVD FL 1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103815",
            "telephone_number": "619-692-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 MORENA BLVD FL 1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103815",
            "telephone_number": "619-692-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTA",
        "first_name": "RYOKO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-14",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW80617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.