Individual provider Active NPI

Jessica Monicco

  • Mental Health Counselor
  • San Ysidro, CA
National Provider Identifier
1851063614
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
85181 Issued in CA
Practice address
416 W San Ysidro Blvd # L-1514
San Ysidro, CA 92173-2443
Phone
(951) 317-0364
NPI assigned
Sep 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 85181 CA Primary

Addresses

Primary practice location

416 W San Ysidro Blvd # L-1514
San Ysidro, CA 92173-2443

Mailing address

416 W San Ysidro Blvd # L-1514
San Ysidro, CA 92173-2443
Phone (951) 317-0364

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
85181CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1851063614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 W SAN YSIDRO BLVD # L-1514",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921732443",
            "telephone_number": "951-317-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 W SAN YSIDRO BLVD # L-1514",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921732443",
            "telephone_number": "951-317-0364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONICCO",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-30",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "85181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ysidro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; 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.