Individual provider Active NPI

Jacob Dylan Guirnalda

  • Case Manager/Care Coordinator
  • San Diego, CA
National Provider Identifier
1902545957
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
10717 Camino Ruiz Ste 207
San Diego, CA 92126-2364
Phone
(858) 695-2211
Fax
(858) 695-3521
NPI assigned
May 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary
Behavior Analyst 103K00000X CA

Addresses

Primary practice location

10717 Camino Ruiz Ste 207
San Diego, CA 92126-2364

Mailing address

10717 Camino Ruiz Ste 207
San Diego, CA 92126-2364
Phone (858) 695-2211

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Research Foundation Inc PastSince Nov 19, 2023 Accepting new patients
Community Research Foundation Inc Case Manager/Care Coordinator PastSince Nov 19, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1653696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1902545957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10717 CAMINO RUIZ STE 207",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262364",
            "telephone_number": "858-695-2211",
            "fax_number": "858-695-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10717 CAMINO RUIZ STE 207",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262364",
            "telephone_number": "858-695-2211",
            "fax_number": "858-695-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIRNALDA",
        "first_name": "JACOB",
        "middle_name": "DYLAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-28",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "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 Nov 15, 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.