Active NPI
Nicole Angelina Mesa
- Clinical Social Worker
- Escondido, CA
National Provider Identifier
1821583980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 96660
- Practice address
- 550 W Washington Ave
Escondido, CA 92025-1643 - Phone
- (760) 489-6380
- NPI assigned
- Jun 29, 2018
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R1486041022 | CA | |
| Clinical Social Worker | 1041C0700X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | 96660 | CA | Primary |
Addresses
Primary practice location
550 W Washington Ave
Escondido, CA 92025-1643
Mailing address
550 W Washington Ave
Escondido, CA 92025-1643
Phone (760) 489-6380
Other practice location 1
333 S Beaudry Ave
Los Angeles, CA 90017-1466
Phone (213) 241-3841
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
| License | State | Type | Specialty |
|---|---|---|---|
| R1486041022 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687824000000",
"number": "1821583980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 W WASHINGTON AVE",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920251643",
"telephone_number": "760-489-6380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 W WASHINGTON AVE",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920251643",
"telephone_number": "760-489-6380"
}
],
"practiceLocations": [
{
"address_1": "333 S Beaudry Ave",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900171466",
"country_code": "US",
"telephone_number": "213-241-3841",
"fax_number": "213-241-3305",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MESA",
"first_name": "NICOLE",
"middle_name": "ANGELINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-29",
"last_updated": "2023-06-27",
"certification_date": "2023-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R1486041022",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "96660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Escondido, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.