Active NPI
Rachel Sutherlin
- Clinical Social Worker
- Encinitas, CA
National Provider Identifier
1609402486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 109253
- Practice address
- 169 Saxony Rd Ste 114
Encinitas, CA 92024-6780 - Phone
- (858) 215-3554
- NPI assigned
- Mar 12, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | 109253 | CA | Primary |
| Behavior Technician | 106S00000X |
Addresses
Primary practice location
169 Saxony Rd Ste 114
Encinitas, CA 92024-6780
Mailing address
169 Saxony Rd Ste 114
Encinitas, CA 92024-6780
Phone (858) 215-3554
Other practice location 1
490 N Grape St
Escondido, CA 92025-3079
Phone (760) 975-9939
Other practice location 2
4719 Viewridge Ave Ste 100
San Diego, CA 92123-1685
Phone (866) 727-8274
Other practice location 3
7907 Ostrow St Ste A
San Diego, CA 92111-3635
Phone (858) 300-8282
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109253 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Research Foundation Inc | Clinical | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- San Diego, CA
- NPI 1952328700
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709510400000",
"number": "1609402486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "169 SAXONY RD STE 114",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "920246780",
"telephone_number": "858-215-3554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 SAXONY RD STE 114",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "920246780",
"telephone_number": "858-215-3554"
}
],
"practiceLocations": [
{
"address_1": "490 N Grape St",
"address_purpose": "LOCATION",
"city": "Escondido",
"state": "CA",
"postal_code": "920253079",
"country_code": "US",
"telephone_number": "760-975-9939",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4719 Viewridge Ave Ste 100",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921231685",
"country_code": "US",
"telephone_number": "866-727-8274",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7907 Ostrow St Ste A",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921113635",
"country_code": "US",
"telephone_number": "858-300-8282",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SUTHERLIN",
"first_name": "RACHEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-12",
"last_updated": "2024-03-04",
"certification_date": "2024-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "109253",
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Encinitas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.