Individual provider Active NPI

Mikeqale Arnold

  • Peer Specialist
  • San Diego, CA
National Provider Identifier
1619702743
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
MPSS-JSGRCY Issued in CA
Practice address
3517 Camino del Rio S Ste 407
San Diego, CA 92108-4028
Phone
(858) 828-6750
NPI assigned
Sep 6, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Day Training/Habilitation Specialist 373H00000X
Peer Specialist 175T00000X MPSS-JSGRCY CA Primary

Addresses

Primary practice location

3517 Camino del Rio S Ste 407
San Diego, CA 92108-4028

Mailing address

3517 Camino del Rio S Ste 407
San Diego, CA 92108-4028
Phone (858) 828-6750

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
MPSS-JSGRCYCAMDPeer Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1619702743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3517 CAMINO DEL RIO S STE 407",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084028",
            "telephone_number": "858-828-6750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3517 CAMINO DEL RIO S STE 407",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084028",
            "telephone_number": "858-828-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "MIKEQALE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-06",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-JSGRCY",
            "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 Jun 19, 2025; 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.