Active NPI
Christina Marie Nakanishi, LCSW
- Clinical Social Worker
- San Diego, CA
National Provider Identifier
1962844233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS# 29601
- Practice address
- 10805 Olivia Way
San Diego, CA 92129-2015 - Phone
- (619) 398-6149
- NPI assigned
- Jul 26, 2013
- 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 | LCS# 29601 | CA | Primary |
Addresses
Primary practice location
10805 Olivia Way
San Diego, CA 92129-2015
Mailing address
10805 Olivia Way
San Diego, CA 92129-2015
Phone (619) 398-6149
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2024 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS# 29601 | CA | MD | Clinical Social Worker |
| 29601 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654473600000",
"number": "1962844233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10805 OLIVIA WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921292015",
"telephone_number": "619-398-6149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10805 OLIVIA WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921292015",
"telephone_number": "619-398-6149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAKANISHI",
"first_name": "CHRISTINA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-26",
"last_updated": "2022-06-06",
"certification_date": "2022-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS# 29601",
"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 Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.