Active NPI
Dara Fedrow
- Professional Counselor
- San Diego, CA
National Provider Identifier
1861133027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- APCC14213
- Practice address
- 8775 Aero Dr Ste 333
San Diego, CA 92123-1756 - Phone
- (858) 384-7035
- NPI assigned
- Apr 3, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | APCC14213 | CA | Primary |
Addresses
Primary practice location
8775 Aero Dr Ste 333
San Diego, CA 92123-1756
Mailing address
8775 Aero Dr Ste 333
San Diego, CA 92123-1756
Phone (858) 384-7035
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 |
|---|---|---|---|
| APCC14213 | CA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Research Foundation, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Step Forward North Central
- Community/Behavioral Health Agency
- San Diego, CA
- NPI 1154544351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710288000000",
"number": "1861133027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8775 AERO DR STE 333",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231756",
"telephone_number": "858-384-7035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8775 AERO DR STE 333",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231756",
"telephone_number": "858-384-7035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDROW",
"first_name": "DARA",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-03",
"last_updated": "2024-03-13",
"certification_date": "2024-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "APCC14213",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.