Individual provider Active NPI

Elizabeth Kaye, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1679883078
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
76288 Issued in CA
Practice address
5252 Balboa Ave Ste 604
San Diego, CA 92117-6933
Phone
(619) 928-4610
Fax
(858) 999-2014
NPI assigned
Oct 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 76288 CA Primary

Addresses

Primary practice location

5252 Balboa Ave Ste 604
San Diego, CA 92117-6933

Mailing address

5252 Balboa Ave Ste 604
San Diego, CA 92117-6933
Phone (619) 928-4610

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
76288CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
San Diego Youth Services 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": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1679883078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5252 BALBOA AVE STE 604",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176933",
            "telephone_number": "619-928-4610",
            "fax_number": "858-999-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5252 BALBOA AVE STE 604",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176933",
            "telephone_number": "619-928-4610",
            "fax_number": "858-999-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYE",
        "first_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "76288",
            "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 Apr 9, 2020; 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.