Justyna Wawrzonek, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

93709 Issued in CA

Practice address

1202 Morena Blvd Ste 300
San Diego, CA 92110-3844

Phone

(619) 275-0822

NPI assigned

Oct 23, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1841701414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1399 9TH AVE APT 1112",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921014749",
            "telephone_number": "860-869-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 MORENA BLVD STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103844",
            "telephone_number": "619-275-0822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 S Highland St",
            "address_purpose": "LOCATION",
            "city": "West Hartford",
            "state": "CT",
            "postal_code": "061191826",
            "country_code": "US",
            "telephone_number": "860-258-4171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAWRZONEK",
        "first_name": "JUSTYNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-23",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "001254",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "10132",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "93709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jessica Wavra
• Vivika Starks Wax, NP
• Wayfinder Behavior Solutions, LLC
• Caroline Waymire
• Barry Anthony Wayne, MD
• Jamie Lou Wayne

• 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 Apr 15, 2020; 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.