Individual provider Active NPI

Jorge Naranjo, M.D.

  • Psychiatry Physician
  • San Diego, CA
National Provider Identifier
1992838684
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A62504 Issued in CA
Practice address
4542 Ruffner Street
Suite 150
San Diego, CA 92111-2238
Phone
(858) 874-8472
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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 A62504 CA Primary

Addresses

Primary practice location

4542 Ruffner Street
Suite 150
San Diego, CA 92111-2238

Mailing address

1866 Gamay Terrace
Chula Vista, CA 91913-1252
Phone (858) 874-8472

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090422000021 CA Practitioner - Psychiatry 7719034149

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A62504CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced TMS Clinic Inc Psychiatry PastSince May 24, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1992838684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1866 GAMAY TERRACE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919131252",
            "telephone_number": "858-874-8472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4542 RUFFNER STREET",
            "address_2": "SUITE 150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921112238",
            "telephone_number": "858-874-8472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NARANJO",
        "first_name": "JORGE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A62504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.