Individual provider Active NPI

Sandra Angelica Saucedo-Salgado, LCSW

  • Clinical Social Worker
  • Chula Vista, CA
National Provider Identifier
1609395292
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
120712 Issued in CA
Practice address
1105 Broadway Ste 207
Chula Vista, CA 91911
Phone
(619) 425-5609
NPI assigned
Sep 14, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 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 120712 CA Primary

Addresses

Primary practice location

1105 Broadway Ste 207
Chula Vista, CA 91911

Mailing address

1105 Broadway Ste 207
Chula Vista, CA 91911-2767

Other practice location 1

264 Landis Ave Ste 101
Chula Vista, CA 91910-2651
Phone (619) 906-5383

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
I20220818002785 CA Practitioner - Clinical Social Worker 3476936741 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
120712CAMDClinical Social Worker
84894CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc. CurrentSince Aug 5, 2022 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Aug 5, 2022 Accepting new patients

Locations

1000 Euclid Ave
National City, CA 91950
Phone (619) 267-8100

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

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": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1609395292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 BROADWAY STE 207",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919112767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 BROADWAY STE 207",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91911",
            "telephone_number": "619-425-5609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "264 Landis Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919102651",
            "country_code": "US",
            "telephone_number": "619-906-5383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAUCEDO-SALGADO",
        "first_name": "SANDRA",
        "middle_name": "ANGELICA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "120712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.