Eddie Agosto
Individual provider Active NPI Social Worker · El Cajon, CA
NPI 1922652452 · NPPES record last updated Aug 1, 2019
Key facts
- NPI
- 1922652452
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- ASW89951 (CA)
- Practice address
- 1400 N Johnson Ave Ste 101
El Cajon, CA 92020-1651 - Phone
- (619) 442-0277
- NPI assigned
- Aug 1, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW89951 | CA | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | ASW89951 | CA | Yes |
Addresses
Primary practice location
1400 N Johnson Ave Ste 101
El Cajon, CA 92020-1651
Mailing address
1400 N Johnson Ave Ste 101
El Cajon, CA 92020-1651
Phone (619) 442-0277
NPI Registry JSON
{
"created_epoch": "1564617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564617600000",
"number": "1922652452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 N JOHNSON AVE STE 101",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920201651",
"telephone_number": "619-442-0277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 N JOHNSON AVE STE 101",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920201651",
"telephone_number": "619-442-0277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGOSTO",
"first_name": "EDDIE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-08-01",
"last_updated": "2019-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "ASW89951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.