Individual provider Active NPI

Kathryn De Oliveira, LCSW

  • Social Worker
  • San Diego, CA
National Provider Identifier
1801699681
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LCSW106939 Issued in CA
Practice address
1650 Garnet Ave # 1125
San Diego, CA 92109-3116
Phone
(619) 333-6057
NPI assigned
Mar 28, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LCSW106939 CA Primary

Addresses

Primary practice location

1650 Garnet Ave # 1125
San Diego, CA 92109-3116

Mailing address

1650 Garnet Ave # 1125
San Diego, CA 92109-3116

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
I20250711000053 CA Practitioner - Clinical Social Worker 7517472426 Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

San Diego, CA 92111
Phone (619) 333-6057

1650 Garnet Ave
Suite 1125
San Diego, CA 92109-3116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW106939CAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1743120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1801699681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 GARNET AVE # 1125",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GARNET AVE # 1125",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093116",
            "telephone_number": "619-333-6057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE OLIVEIRA",
        "first_name": "KATHRYN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-28",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LCSW106939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.