Individual provider Active NPI

Jocelia Juah Kidio

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1881140770
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
88039 Issued in CA
Practice address
1865 Hotel Cir S
San Diego, CA 92108-3319
Phone
(619) 712-9117
Fax
(858) 292-0322
NPI assigned
Aug 30, 2016
Last updated
Mar 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Social Worker 1041C0700X 88039 CA Primary

Addresses

Primary practice location

1865 Hotel Cir S
San Diego, CA 92108-3319

Mailing address

1865 Hotel Cir S
San Diego, CA 92108-3319
Phone (619) 712-9117

Other practice location 1

8775 Aero Dr Ste 132
San Diego, CA 92123-1779
Phone (858) 609-8742

Other practice location 2

4283 El Cajon Blvd Ste 115
San Diego, CA 92105-1289
Phone (619) 521-1743

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
88039CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1881140770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 HOTEL CIR S",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083319",
            "telephone_number": "619-712-9117",
            "fax_number": "858-292-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 HOTEL CIR S",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083319",
            "telephone_number": "619-712-9117",
            "fax_number": "858-292-0322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8775 Aero Dr Ste 132",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921231779",
            "country_code": "US",
            "telephone_number": "858-609-8742",
            "fax_number": "858-292-0322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4283 El Cajon Blvd Ste 115",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921051289",
            "country_code": "US",
            "telephone_number": "619-521-1743",
            "fax_number": "619-521-1896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIDIO",
        "first_name": "JOCELIA",
        "middle_name": "JUAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "88039",
            "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 8, 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.

Verify at the official NPI Registry.