Individual provider Active NPI

Katie Marie Rasakatla Jorstad, LCSW

  • Clinical Social Worker
  • San Marcos, CA
National Provider Identifier
1912138587
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
330 Rancheros Dr Ste 208
San Marcos, CA 92069-2978
Phone
(760) 571-9807
NPI assigned
Jul 30, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS28462 CA
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

330 Rancheros Dr Ste 208
San Marcos, CA 92069-2978

Mailing address

330 Rancheros Dr Ste 208
San Marcos, CA 92069-2978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171208001792 CA Practitioner - Clinical Social Worker 5698930527 Practice locations: San Marcos, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

365 S Rancho Santa Fe Rd
Suite 204
San Marcos, CA 92078-2338
Phone (760) 571-9807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS28462CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1912138587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 RANCHEROS DR STE 208",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 RANCHEROS DR STE 208",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692978",
            "telephone_number": "760-571-9807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORSTAD",
        "first_name": "KATIE",
        "middle_name": "MARIE RASAKATLA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-30",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS28462",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

Verify at the official NPI Registry.