Terri Lynne Kisselovich, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

27673 Issued in CA

Practice address

8881 Fletcher Pkwy Ste 350-360
La Mesa, CA 91942-3134

Phone

(858) 279-1223

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of San Diego

  • Public Health or Welfare Agency
  • San Diego, CA
  • NPI 1225255375
  Medicare reassignment NPD
• Pacific Coast Psychiatric Associates Inc

  dba Lifestance Health

  • Clinical Psychologist
  • Scottsdale, AZ
  • NPI 1023125465

  CA

  Medicare reassignment NPD
• County of San Diego

  dba San Diego County Fire Protection District

  • Ambulance
  • San Diego, CA
  • NPI 1316685159
  NPD
• County of San Diego

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1336209220
  NPD
• William L. Wilson, M.D., Inc.

  dba California Pain and Spine Care

  • Interventional Pain Medicine Physician
  • La Mesa, CA
  • NPI 1568424687
  NPD

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1841386885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8881 FLETCHER PKWY STE 350-360",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8881 FLETCHER PKWY STE 350-360",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423134",
            "telephone_number": "858-279-1223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 Morena Blvd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921103815",
            "country_code": "US",
            "telephone_number": "619-692-8750",
            "fax_number": "619-275-7343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISSELOVICH",
        "first_name": "TERRI",
        "middle_name": "LYNNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "27673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas S. Kilcheski, M.D.
• Jennifer Kim, M.D.
• Joseph Kim, PHARMD
• Laura Lenell King, MA
• Patricia Kiriazis, MASSAGE THERAPIST
• Sofia Klar
• Robert Scott Klein, D.O.
• Brian M Kleker, M.D.
• Nora Jane Klemenz, LMFT
• Rachel Klimochkin, RRT

• Clinical Social Worker in La Mesa, CA
• Providers in La Mesa, 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 May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.