KATHLEEN H MAIETTA (NPI# 1487128617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487128617 |
| Entity Type | Individual |
| Full Name | KATHLEEN H MAIETTA |
| Other Name | KATHLEEN H RYDER |
| Credential | LCSW |
| Practice Address |
4725 Market St San Diego CA 92102 |
| Mailing Address |
2865 Logan Ave San Diego CA 92113-2411 |
| Practice Telephone | 8609653818 |
| Mailing Telephone | 6192324357 |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2019-04-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
121686 | MA | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
121686 | MA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1487128617 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2865 Logan Ave, San Diego, CA 92113 | 6192324357 |
| Street Address |
4725 MARKET ST |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346276540 | Justina Jennan Tseng | Internal Medicine | 4725 Market St, San Diego, CA 92102-4715 | 2006-06-23 |
| 1134686744 | Sarah Nicole Goldfinger | Nurse Practitioner | 4725 Market St, San Diego, CA 92102-4715 | 2019-03-01 |
| 1942764477 | Yuin-wah Lum | Nurse Practitioner | 4725 Market St, San Diego, CA 92102-4715 | 2019-01-29 |
| 1255785150 | Jennifer Kay Chen | Pediatrics | 4725 Market St, San Diego, CA 92102 | 2016-04-17 |
| 1225463730 | Jennifer Stacia Fuller-christie | Nurse Practitioner | 4725 Market St, San Diego, CA 92102-4715 | 2013-09-04 |
| 1235576059 | Lisa Marie Songco Hamilton | Family Medicine | 4725 Market St, San Diego, CA 92102-4715 | 2013-06-03 |
| 1275892754 | Srividya Narasimhan Sampath | Pediatrics | 4725 Market St, San Diego, CA 92102-4715 | 2012-05-03 |
| 1679859250 | Brittanie Lee Eggan | Physician Assistant | 4725 Market St, San Diego, CA 92102-4715 | 2011-10-27 |
| 1649564295 | Sheena M Ogando | Internal Medicine | 4725 Market St, San Diego, CA 92102-4715 | 2011-05-31 |
| 1831482892 | Steven J Arias | Psychologist | 4725 Market St, San Diego, CA 92102 | 2011-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437766698 | Daniela Tablas | Behavioral Analyst | 303 47th St Spc D-22, San Diego, CA 92102 | 2020-09-30 |
| 1649745712 | Juliet Lao Kurek | Pharmacist | 2121 Imperial Avenue, San Diego, CA 92102 | 2018-10-04 |
| 1851887020 | Monique Joseph | Counselor | 2410 E. Street, San Diego, CA 92102 | 2018-07-10 |
| 1184166316 | Elise Blanton-hubbard | Counselor | 1850 Dale St, San Diego, CA 92102 | 2016-11-04 |
| 1699221416 | Kari Judith Medina | Student in an Organized Health Care Education/Training Program | 1199 34th Street Apt 11, San Diego, CA 92102 | 2016-08-31 |
| 1942674536 | Caitlin Hillary Dablow | Speech-Language Pathologist | 1201 34th Street, San Diego, CA 92102 | 2015-11-19 |
| 1134508179 | Jonathan Waters | Military Health Care Provider | 1233 22nd Street, Unit 8, San Diego, CA 92102 | 2015-05-22 |
| 1871989913 | Abraham Greenberg | Pediatrics | 15 Balfour Street, Jerusalem, ISRAEL 92102 | 2015-04-15 |
| 1023421021 | Elmira Aghdam | Chiropractor | 5030 Bonita Rd Ste#b, Bonita, CA 92102 | 2014-06-06 |
| 1487092540 | Sherry Scott | Marriage & Family Therapist | 995 Gateway Center Drive #300, San Diego, CA 92102 | 2013-06-11 |
| Find all providers in zip 92102 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396346359 | Christina L Thomas | Counselor | 4611 Alamo Dr, San Diego, CA 92115-5907 | 2020-11-05 |
| 1639779101 | Paula Perez | Counselor | 5882 Adobe Falls Rd, San Diego, CA 92120-4600 | 2020-10-26 |
| 1558974378 | Monica Dixon | Counselor | 4930 Naples St Fl 1, San Diego, CA 92110-3820 | 2020-08-31 |
| 1952911612 | Shannon Kathleen Nolte | Counselor | 13111 Kellam Ct Apt 9, San Diego, CA 92130-1251 | 2020-08-06 |
| 1033728498 | Hala Kadhem | Counselor | 1664 Broadway, El Cajon, San Diego, CA 92021 | 2020-07-30 |
| 1487279493 | Christi Susan Leyva | Counselor | 10417 Crosscreek Ter, San Diego, CA 92131-1344 | 2020-06-15 |
| 1285256099 | Jehna Barnes | Counselor | 3636 Camino Del Rio N, San Diego, CA 92108-1703 | 2020-05-14 |
| 1457973455 | Cassandra Detgen | Counselor | 5252 Orange Ave Unit 125, San Diego, CA 92115-6029 | 2020-05-12 |
| 1972131589 | Douglas Baker Marriage and Family Therapy, Inc. | Counselor | 2911 Adams Ave # 5, San Diego, CA 92116-1509 | 2020-03-30 |
| 1255966859 | Job Brunat | Counselor | 4169 38th St Apt 10, San Diego, CA 92105-1367 | 2020-03-04 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.