Individual provider Active NPI

Cara Elizabeth Fairfax, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1952422008
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
18858 Issued in CA
Practice address
7339 El Cajon Blvd
Suite K
San Diego, CA 91941
Phone
(619) 668-6200
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 18858 CA Primary

Addresses

Primary practice location

7339 El Cajon Blvd
Suite K
San Diego, CA 91941

Mailing address

11025 Fuerte Dr
La Mesa, CA 91941-7161
Phone (619) 219-4313

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
18858CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1952422008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11025 FUERTE DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919417161",
            "telephone_number": "619-219-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7339 EL CAJON BLVD",
            "address_2": "SUITE K",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "91941",
            "telephone_number": "619-668-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRFAX",
        "first_name": "CARA",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "18858",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.