Active NPI
Debra Blay Holmes, LCSW
- Clinical Social Worker
- San Diego, CA
National Provider Identifier
1932192531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS20238
- Practice address
- 3821 Front St
San Diego, CA 92103-3019 - Phone
- (619) 297-0023
- NPI assigned
- Aug 30, 2005
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS20238 | CA | Primary |
Addresses
Primary practice location
3821 Front St
San Diego, CA 92103-3019
Mailing address
3821 Front St
San Diego, CA 92103-3019
Phone (619) 297-0023
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LCS20238 | Other | CA | BLUE CROSS OF CALIFORNIA |
| CSW202380 | Medicaid | CA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS20238 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595462400000",
"number": "1932192531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3821 FRONT ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921033019",
"telephone_number": "619-297-0023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3821 FRONT ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921033019",
"telephone_number": "619-297-0023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "DEBRA",
"middle_name": "BLAY",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-08-30",
"last_updated": "2020-07-23",
"certification_date": "2020-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS20238",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF CALIFORNIA",
"identifier": "LCS20238",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CSW202380",
"state": "CA"
}
],
"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 Jul 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.