Individual provider Active NPI

Rachel Sutherlin

  • Clinical Social Worker
  • Encinitas, CA
National Provider Identifier
1609402486
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
109253 Issued in CA
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

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
109253CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.