Active NPI
Suyapa Liliana Ulloa, LCSW
- Clinical Social Worker
- San Diego, CA
National Provider Identifier
1700169208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 85621
- Practice address
- 1202 Morena Blvd Ste 300
San Diego, CA 92110-3844 - Phone
- (619) 276-8122
- NPI assigned
- Sep 21, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Rehabilitation Practitioner | 225400000X | |||
| Clinical Social Worker | 1041C0700X | 85621 | CA | Primary |
Addresses
Primary practice location
1202 Morena Blvd Ste 300
San Diego, CA 92110-3844
Mailing address
3435 Camino del Rio S Ste 203a
San Diego, CA 92108-3911
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stonebridge Counseling Inc | Clinical | 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": "1316563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672704000000",
"number": "1700169208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3435 CAMINO DEL RIO S STE 203A",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921083911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1202 MORENA BLVD STE 300",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921103844",
"telephone_number": "619-276-8122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ULLOA",
"first_name": "SUYAPA",
"middle_name": "LILIANA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-21",
"last_updated": "2023-01-03",
"certification_date": "2023-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "85621",
"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 Jan 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.