Patricia Chris Kantzavelos, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

73271 Issued in CA

Practice address

4142 Adams Ave
Unit 103-123
San Diego, CA 92116-2592

Phone

(310) 600-5479

NPI assigned

Aug 17, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Christina Patricia Kantzavelos Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1811202609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4142 ADAMS AVE",
            "address_2": "UNIT 103-123",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921162592",
            "telephone_number": "310-600-5479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4142 ADAMS AVE",
            "address_2": "UNIT 103-123",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921162592",
            "telephone_number": "310-600-5479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANTZAVELOS",
        "first_name": "PATRICIA",
        "middle_name": "CHRIS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "73271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "KANTZAVELOS",
            "middle_name": "PATRICIA",
            "prefix": "MISS",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Simone Elise Kanter, M.D.
• Tina Huynh Kantharia, M.D.
• Ibolya M Kantor, PH.D.
• Julia Kantor, PT, DPT
• Molly Anne Marie Kantor, M.D.
• Cade Kanzius
• Allen Shiufan Kao, DPT
• Daniel Kao, M.D., M.P.H.
• Erika M. Kao, PH.D.
• Michael Chun-Yuen Kao, MD

• 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 Sep 20, 2018; 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.