Kristyne Skippergosh, ASW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

90784 Issued in CA

Practice address

5252 Balboa Ave Ste 800
San Diego, CA 92117-6970

Phone

(619) 404-0578

NPI assigned

Jun 27, 2016

Last updated

Oct 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lucks Psychology, Inc

  • Group Psychotherapy Psychologist
  • San Diego, CA
  • NPI 1841421328
  Medicare reassignment NPD
• Skippergosh Therapy Licensed Clinical Social Worker Inc

  dba Skippergosh Therapy and Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
  • NPI 1760107114
  NPD Authorized official

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1932550407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 GATEWAY CENTER WAY STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024550",
            "telephone_number": "619-398-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5252 BALBOA AVE STE 800",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176970",
            "telephone_number": "619-404-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIPPERGOSH",
        "first_name": "KRISTYNE",
        "credential": "ASW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "77865",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801099324",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "90784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Jacaruso Skinner, PT
• Richard William Skinner, DO
• Taylor McKenzie Skinner
• Skintegration Management
• Skippergosh Therapy Licensed Clinical Social Worker Inc (Skippergosh Therapy and Counseling)
• Lynette Faye Skippon, CCC-SLP
• John Skirgaudas, MD
• Marc Benjamin Sklar, LAC, DA (RI)
• Nadav Rick Sklar, MFT
• Julie M. Sklenicka, PHARM.D.

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.