Individual provider Active NPI

Maria Alcorn

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1689233546
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
109289 Issued in CA
Practice address
545 Laurel St
San Diego, CA 92101-1634
Phone
(619) 233-4399
NPI assigned
Jun 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 109289 CA Primary

Addresses

Primary practice location

545 Laurel St
San Diego, CA 92101-1634

Mailing address

3132 Jefferson St
San Diego, CA 92110-4421
Phone (619) 683-3100

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
I20230203001753 CA Practitioner - Clinical Social Worker 7113399924 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Research Foundation Inc Clinical CurrentSince Jan 1, 2023 Accepting new patients
Community Research Foundation Inc Past Accepting new patients
Community Research Foundation Inc PastSince Jan 1, 2023 Accepting new patients
Pasadena Clinical Group, a Psychology Corporation Past Accepting new patients

Locations

1202 Morena Blvd
Ste 100
San Diego, CA 92110
Phone (619) 276-8112

1202 Morena Blvd
Ste 300
San Diego, CA 92110
Phone (619) 276-8112

545 Laurel St
San Diego, CA 92101
Phone (619) 233-4399

Organizations & group practices 5

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": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1689233546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3132 JEFFERSON ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104421",
            "telephone_number": "619-683-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 LAUREL ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011634",
            "telephone_number": "619-233-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALCORN",
        "first_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2023-01-12",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": "109289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.