Individual provider Active NPI

Kristine Mateos

  • School Social Worker
  • Tucson, AZ
National Provider Identifier
1811101181
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
10324 Issued in AZ
Practice address
1010 E 10TH St
Tucson, AZ 85719-5813
Phone
(520) 232-6100
NPI assigned
May 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 10324 AZ Primary

Addresses

Primary practice location

1010 E 10TH St
Tucson, AZ 85719-5813

Mailing address

6481 N Mona Lisa Rd
Tucson, AZ 85741-3132
Phone (520) 797-9100

Other identifiers 1

IdentifierTypeStateIssuer
811316MedicaidAZ

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

LicenseStateTypeSpecialty
10324AZMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811101181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6481 N MONA LISA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413132",
            "telephone_number": "520-797-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 E 10TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857195813",
            "telephone_number": "520-232-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEOS",
        "first_name": "KRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "AZ",
            "license": "10324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "811316",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.