SANDRA M KOELLMANN ASW
NPI 1073131033
Social Worker - Clinical in San Diego, CA

Q: What is Sandra Koellmann's NPI number?

The NPI number for Sandra Koellmann is 1073131033. It was assigned to this individual provider in the NPPES registry on July 7, 2020.

Q: What is Sandra Koellmann's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: Is Sandra Koellmann enrolled in Medicare?

No. Sandra Koellmann has opted out of Medicare through December 18, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Sandra Koellmann was last updated on July 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 07, 2020Opted out of Medicare · through Dec 18, 2027

3767 CENTRAL AVE, SAN DIEGO, CA 92105(619) 584-4010(619) 278-0770 Get Directions Write a Review

NPPES record last updated: July 7, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Sandra M Koellmann Asw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SANDRA M KOELLMANN ASW (NPI 1073131033) is an individual clinical provider in San Diego, California, licensed in California (86201) and active in the NPI registry since July 2020. She has opted out of Medicare through December 18, 2027.

NPPES Registry Identity

NPI1073131033

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameSANDRA M KOELLMANNCredential: ASW

Location Address3767 CENTRAL AVESan Diego, CA 92105-2599

Mailing Address3767 Central AveSan Diego, CA 92105-2599

Phone(619) 584-4010

Fax(619) 278-0770

Sole ProprietorNo

Enumeration DateJuly 7, 2020

NPPES CertifiedJuly 7, 2020

✔ NPI 1073131033 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in CA · 86201

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

3767 CENTRAL AVE, San Diego, CA 92105

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Sandra M Koellmann Asw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 18, 2023 through December 18, 2027.

Opt-Out Effective DateDecember 18, 2023

Opt-Out In Effect ThroughDecember 18, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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