San Diego State University - Healthy Early Years Clinic
NPI 1124849658ActiveOrganization· Counselor· San Diego, CA
Counselor in San Diego, California, registered in NPPES in October 2024, part of San Diego State University. The authorized official on file is Agnes Wong Nickerson, Associate Vp Of Financial Operation.
Overview
| NPI | 1124849658 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | San Diego State University |
| NPI issued | Oct 17, 2024 |
| Last updated in NPPES | Oct 17, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor Primary | 101Y00000X | — | — |
| Social Worker | 104100000X | — | — |
| Marriage & Family Therapist | 106H00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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