Individual provider Active NPI

David Moss, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1629121249
Registry record updated Apr 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22785 Issued in CA
Practice address
9330 Carmel Mountain Rd Ste C
San Diego, CA 92129-2100
Phone
(619) 750-5333
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2020

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 22785 CA Primary

Addresses

Primary practice location

9330 Carmel Mountain Rd Ste C
San Diego, CA 92129-2100

Mailing address

17765 Pennacook CT
San Diego, CA 92127-1369
Phone (619) 248-3016

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
I20081219000284 CA Practitioner - Clinical Social Worker 9133281488 Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

16935 W Bernardo Dr
Suite 104
San Diego, CA 92127-1635
Phone (619) 750-5333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22785CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
David S. Janowsky 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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586476800000",
    "number": "1629121249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17765 PENNACOOK CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271369",
            "telephone_number": "619-248-3016",
            "fax_number": "858-674-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9330 CARMEL MOUNTAIN RD STE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292100",
            "telephone_number": "619-750-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "DAVID",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "22785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.