Active NPI
Jeanmarie Mangindin, LICSW
- Clinical Social Worker
- San Diego, CA
National Provider Identifier
1982808283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC3000795
- Practice address
- 46141 Miramar Way Ste 1
San Diego, CA 92145-5401 - Phone
- (858) 577-7079
- NPI assigned
- Jun 12, 2007
- Sex
- Female
- 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 | LC3000795 | DC | Primary |
Addresses
Primary practice location
46141 Miramar Way Ste 1
San Diego, CA 92145-5401
Mailing address
46141 Miramar Way Ste 1
PO Box 452135
San Diego, CA 92145-5401
Phone (858) 577-7079
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
| License | State | Type | Specialty |
|---|---|---|---|
| LC3000795 | DC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982808283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46141 MIRAMAR WAY STE 1",
"address_2": "PO BOX 452135",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921455401",
"telephone_number": "858-577-7079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46141 MIRAMAR WAY STE 1",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921455401",
"telephone_number": "858-577-7079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGINDIN",
"first_name": "JEANMARIE",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "LC3000795",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.