Porta Verum

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

25403 Issued in CA

Legal business name

PORTA VERUM

Practice address

2630 1St Ave
Suite 205
San Diego, CA 92103-6599

Phone

(619) 866-4620

Fax

(619) 324-1023

NPI assigned

Nov 5, 2012

Organization subpart

No

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

Authorized official

Name

Paula Kettula, LCSW

Title

Owner

Phone

(619) 866-4620

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384732800000",
    "number": "1740534239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 1ST AVE",
            "address_2": "SUITE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036599",
            "telephone_number": "619-866-4620",
            "fax_number": "619-324-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 1ST AVE",
            "address_2": "SUITE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036599",
            "telephone_number": "619-866-4620",
            "fax_number": "619-324-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTA VERUM",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-05",
        "last_updated": "2013-11-18",
        "status": "A",
        "authorized_official_last_name": "KETTULA",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-866-4620",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "25403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Porcil
• Rea Ordono Porciuncula, R.N., B.S.N.
• Belinda Pornel, RN
• Elena Porras
• Vanessa Maria Porras
• Krystal Rosebud Portalatin, B.A.
• Lilia Katherine Portales, DDS
• Debra Denise Portee
• Lucilia Goncalves Portela, PT, DPT
• Annalisa Porter, PHARM.D.

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; 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.