Active NPI
Alexandra Poling, LCSW
- Clinical Social Worker
- Carlsbad, CA
National Provider Identifier
1629338694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 79809
- Practice address
- 2890 Pio Pico Dr Ste 200B
Carlsbad, CA 92008-1558 - Phone
- (760) 487-8474
- NPI assigned
- May 23, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 79809 | CA | Primary |
Addresses
Primary practice location
2890 Pio Pico Dr Ste 200B
Carlsbad, CA 92008-1558
Mailing address
2890 Pio Pico Dr Ste 200B
Carlsbad, CA 92008-1558
Phone (760) 487-8474
Other practice location 1
734 10th Ave
San Diego, CA 92101-6502
Phone (619) 239-4663
Other practice location 2
3252 Holiday Ct Ste 102
LA Jolla, CA 92037
Phone (858) 224-2487
Other names 1
- Alexandra Mazzulo
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 |
|---|---|---|---|
| 79809 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Research Foundation Inc | Clinical | Past | Accepting new patients |
| Community Research Foundation Inc | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- San Diego, CA
- NPI 1346463932
-
- 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": "1337731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625961600000",
"number": "1629338694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2890 PIO PICO DR STE 200B",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920081558",
"telephone_number": "760-487-8474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2890 PIO PICO DR STE 200B",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920081558",
"telephone_number": "760-487-8474"
}
],
"practiceLocations": [
{
"address_1": "734 10th Ave",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921016502",
"country_code": "US",
"telephone_number": "619-239-4663",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3252 Holiday Ct Ste 102",
"address_purpose": "LOCATION",
"city": "LA Jolla",
"state": "CA",
"postal_code": "92037",
"country_code": "US",
"telephone_number": "858-224-2487",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POLING",
"first_name": "ALEXANDRA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-23",
"last_updated": "2021-07-11",
"certification_date": "2021-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "79809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ALEXANDRA",
"last_name": "MAZZULO",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Carlsbad, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.