Active NPI
Natasha Bavolar
- Mental Health Counselor
- San Diego, CA
National Provider Identifier
1639740236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 12803
- Practice address
- 4930 Naples St
San Diego, CA 92110-3820 - Phone
- (619) 276-1176
- NPI assigned
- Jul 5, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 12803 | MA | Primary |
| Case Manager/Care Coordinator | 171M00000X |
Addresses
Primary practice location
4930 Naples St
San Diego, CA 92110-3820
Mailing address
4930 Naples St
San Diego, CA 92110-3820
Phone (619) 276-1176
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12803 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641859200000",
"number": "1639740236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4930 NAPLES ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921103820",
"telephone_number": "619-276-1176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4930 NAPLES ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921103820",
"telephone_number": "619-276-1176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAVOLAR",
"first_name": "NATASHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-05",
"last_updated": "2022-01-11",
"certification_date": "2022-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "12803",
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
}
],
"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 Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.