Individual provider Active NPI

Tiffany Lin Lasky

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1972989606
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
97597 Issued in CA
Practice address
1031 25TH St
San Diego, CA 92102-2102
Phone
(619) 232-6454
NPI assigned
Aug 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 77134 CA
Mental Health Counselor 101YM0800X 77134 CA
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 97597 CA Primary

Addresses

Primary practice location

1031 25TH St
San Diego, CA 92102-2102

Mailing address

1031 25TH St
San Diego, CA 92102-2102
Phone (619) 232-6454

Other practice location 1

140 Arbor Dr
San Diego, CA 92103-2007
Phone (619) 543-7795

Other practice location 2

5296 University Ave Ste F2
San Diego, CA 92105-2269
Phone (619) 578-2211 ext. 204

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
77134CAMDCounselor
97597CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1972989606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 25TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921022102",
            "telephone_number": "619-232-6454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 25TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921022102",
            "telephone_number": "619-232-6454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921032007",
            "country_code": "US",
            "telephone_number": "619-543-7795",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5296 University Ave Ste F2",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921052269",
            "country_code": "US",
            "telephone_number": "619-578-2211 x204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LASKY",
        "first_name": "TIFFANY",
        "middle_name": "LIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-04",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "77134",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "77134",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "97597",
            "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 Oct 19, 2020; 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.