Active NPI
Holly Kristine Fay, LCSW
- Clinical Social Worker
- Chula Vista, CA
National Provider Identifier
1699043075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 65725
- Practice address
- 430 F St
Chula Vista, CA 91910-3711 - Phone
- (619) 420-3620
- Fax
- (619) 420-8722
- NPI assigned
- Dec 13, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 65725 | CA | Primary |
Addresses
Primary practice location
430 F St
Chula Vista, CA 91910-3711
Mailing address
430 F St
Chula Vista, CA 91910-3711
Phone (619) 420-3620
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 |
|---|---|---|---|
| 65725 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433808000000",
"number": "1699043075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 F ST",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919103711",
"telephone_number": "619-420-3620",
"fax_number": "619-420-8722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 F ST",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919103711",
"telephone_number": "619-420-3620",
"fax_number": "619-420-8722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAY",
"first_name": "HOLLY",
"middle_name": "KRISTINE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-13",
"last_updated": "2015-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "65725",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chula Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.