Active NPI
Jorge Avalos
- Clinical Social Worker
- Chula Vista, CA
National Provider Identifier
1932696192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 97356
- Practice address
- 855 3Rd Ave Ste 1110
Chula Vista, CA 91911-1350 - Phone
- (619) 934-5770
- Fax
- (619) 391-0091
- NPI assigned
- Apr 13, 2018
- Last updated
- Feb 1, 2023
- Sex
- Male
- Sole proprietor
- No
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 | 97356 | CA | Primary |
Addresses
Primary practice location
855 3Rd Ave Ste 1110
Chula Vista, CA 91911-1350
Mailing address
855 3Rd Ave Ste 1110
Chula Vista, CA 91911-1350
Phone (619) 934-5770
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 97356 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Research Foundation Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Hawthorne Crisis Center
- Community/Behavioral Health Agency
- San Diego, CA
- NPI 1225251812
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675209600000",
"number": "1932696192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 3RD AVE STE 1110",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919111350",
"telephone_number": "619-934-5770",
"fax_number": "619-391-0091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 3RD AVE STE 1110",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919111350",
"telephone_number": "619-934-5770",
"fax_number": "619-391-0091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVALOS",
"first_name": "JORGE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-13",
"last_updated": "2023-02-01",
"certification_date": "2023-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "97356",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chula Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.