Individual provider Active NPI

Yuliya Eduardovna Proosaselts, M.D.

  • Psychiatry Physician
  • San Diego, CA
National Provider Identifier
1952747875
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A133675 Issued in CA
Practice address
1250 6TH Ave Ste 100
San Diego, CA 92101-4368
Phone
(619) 515-2430
NPI assigned
May 18, 2013
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A133675 CA Primary

Addresses

Primary practice location

1250 6TH Ave Ste 100
San Diego, CA 92101-4368

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541

Other practice location 1

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300

Other practice location 2

3544 30th St
San Diego, CA 92104-4120
Phone (619) 515-2424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150925002346 CA Practitioner - Psychiatry 7517275431 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
133675CAMDMarriage & Family Therapist
A133675CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Diego Current Accepting new patients
County of San Diego CurrentSince Aug 9, 2015 Accepting new patients
County of San Diego CurrentSince Aug 9, 2015 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Feb 27, 2019 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Feb 27, 2019 Accepting new patients

Locations

1000 Broadway
Ste 210
El Cajon, CA 92021
Phone (619) 401-5500

1250 6th Ave
Ste 100
San Diego, CA 92101
Phone (619) 515-2430

1250 Morena Blvd
San Diego, CA 92110
Phone (619) 692-8715

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

3177 Ocean View Blvd
San Diego, CA 92113
Phone (619) 231-9300

3544 30th St
San Diego, CA 92104
Phone (619) 515-2424

3853 Rosecrans St
San Diego, CA 92110
Phone (619) 615-0439

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1368835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1952747875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 6TH AVE STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921014368",
            "telephone_number": "619-515-2430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "823 Gateway Center Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921024541",
            "country_code": "US",
            "telephone_number": "619-515-2300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3544 30th St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921044120",
            "country_code": "US",
            "telephone_number": "619-515-2424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROOSASELTS",
        "first_name": "YULIYA",
        "middle_name": "EDUARDOVNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A133675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.