Active NPI
Melissa Miller, LCSW
- Clinical Social Worker
- San Diego, CA
National Provider Identifier
1992856439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 26666
- Practice address
- 200 W Arbor Dr
San Diego, CA 92103-9000 - Phone
- (858) 610-7057
- NPI assigned
- Jan 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | 26666 | CA | Primary |
Addresses
Primary practice location
200 W Arbor Dr
San Diego, CA 92103-9000
Mailing address
200 W Arbor Dr
San Diego, CA 92103-9000
Other names 1
- Melissa Goodrich
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639526400000",
"number": "1992856439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 W ARBOR DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921039000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W ARBOR DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921039000",
"telephone_number": "858-610-7057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "MELISSA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-12",
"last_updated": "2021-12-15",
"certification_date": "2021-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "26666",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4647 Zion Ave",
"city": "San Diego",
"state": "CA",
"country_code": "US",
"postal_code": "921202507",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "GOODRICH",
"code": "1",
"type": "Former Name"
}
]
}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 Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.