Individual provider Active NPI

Katari Amina Campbell, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1598030207
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
93268 Issued in CA
Practice address
1660 Hotel Cir N Ste 101
San Diego, CA 92108-2801
Phone
(619) 961-2120
NPI assigned
Mar 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CA
Clinical Social Worker 1041C0700X 93268 CA Primary

Addresses

Primary practice location

1660 Hotel Cir N Ste 101
San Diego, CA 92108-2801

Mailing address

1660 Hotel Cir N Ste 101
San Diego, CA 92108-2801
Phone (619) 961-2120

Other practice location 1

4094 4th Ave
San Diego, CA 92103-2143
Phone (619) 515-2545

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
I20230810003781 CA Practitioner - Clinical Social Worker 4284096017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Centers of San Diego IncGroup PAC ID 3476446378, 299 clinicians

Practice addresses (Care Compare)

4065 3Rd Ave
San Diego, CA 92103-2184
Phone (619) 515-2545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Jul 31, 2023 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients

Locations

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

4094 4th Ave
San Diego, CA 92103
Phone (619) 515-2545

Organizations & group practices 2

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": "1331596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1598030207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 HOTEL CIR N STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082801",
            "telephone_number": "619-961-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 HOTEL CIR N STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082801",
            "telephone_number": "619-961-2120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4094 4th Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921032143",
            "country_code": "US",
            "telephone_number": "619-515-2545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "KATARI",
        "middle_name": "AMINA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-13",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "93268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.