Active NPI
John E Roberts, LCSW
- Clinical Social Worker
- San Diego, CA
National Provider Identifier
1598960569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LV11144
- Practice address
- 3420 Kenyon St
San Diego, CA 92110-5001 - Phone
- (619) 221-6101
- NPI assigned
- Jun 19, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LV11144 | CA | Primary |
Addresses
Primary practice location
3420 Kenyon St
San Diego, CA 92110-5001
Mailing address
1869 Wedgemere Rd
El Cajon, CA 92020-2239
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LV11144 | CA | MD | Clinical Social Worker |
| 11144 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598960569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1869 WEDGEMERE RD",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920202239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3420 KENYON ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921105001",
"telephone_number": "619-221-6101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "JOHN",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LV11144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.