Individual provider Active NPI

Makenna Cie Palomino, RADT

  • Addiction (Substance Use Disorder) Counselor
  • San Diego, CA
National Provider Identifier
1659745396
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
RH0008850522 Issued in CA
Practice address
7545 Metropolitan Dr
San Diego, CA 92108-4402
Phone
(619) 966-3352
NPI assigned
Nov 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X RH0008850522 CA Primary

Addresses

Primary practice location

7545 Metropolitan Dr
San Diego, CA 92108-4402

Mailing address

7545 Metropolitan Dr
San Diego, CA 92108-4402
Phone (619) 966-3352

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
RH0008850522CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1659745396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7545 METROPOLITAN DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084402",
            "telephone_number": "619-966-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7545 METROPOLITAN DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084402",
            "telephone_number": "619-966-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALOMINO",
        "first_name": "MAKENNA",
        "middle_name": "CIE",
        "credential": "RADT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-18",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "RH0008850522",
            "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 Sep 19, 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.

Verify at the official NPI Registry.