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VANESSA ICAZBALCETA-SOTO
NPI 1083264519
Counselor - Professional in San Diego, CA

Active since September 17, 2019PECOS Enrolled
9265 SKY PARK CT STE 100, SAN DIEGO, CA 92123(706) 524-7134 Get Directions Write a Review

NPPES record last updated: October 16, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 25, 2024, Sep 17, 2019 (2 updates tracked since 2019).

About Vanessa Icazbalceta-soto NPPES

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

VANESSA ICAZBALCETA-SOTO (NPI 1083264519) is an individual professional provider in San Diego, California, licensed in California (15849) and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Los Angeles, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1083264519
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameVANESSA ICAZBALCETA-SOTO
Location Address9265 SKY PARK CT STE 100San Diego, CA 92123-4375
Mailing Address201 N Brand Blvd #200Los Angeles, CA 91203-1519 · (562) 888-0285
Phone(706) 524-7134
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateSeptember 17, 2019
Last NPPES UpdateOctober 16, 20242 updates tracked since enumeration
NPPES CertifiedOctober 16, 2024
✔ NPI 1083264519 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in CA · 15849
9265 SKY PARK CT STE 100, San Diego, CA 92123
Open in Google Maps ↗

Other Names 1

Former Name (1)Vanessa Icazbalceta

Secondary Practice Location 1

Location 1201 N Brand Blvd Unit 200Los Angeles, CA 91203 · Phone (562) 888-0285

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Vanessa Icazbalceta-soto is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3173061579
PECOS Enrollment IDI20260603003903
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Vanessa Icazbalceta-soto reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Serene Health
Same address
Mental Health
9265 SKY PARK CT STE 100
San Diego, CA 92123
  • Reassigned Medicare billing, California enrollment
  • 25 clinicians in this Medicare group
NPI 1649809526 (844) 737-3638
Sud Specialty Group - Ca
419 mi
Addiction Medicine
4633 OLD IRONSIDES DR STE 304
Santa Clara, CA 95054
  • Reassigned Medicare billing, California enrollment
  • 1,607 clinicians in this Medicare group
NPI 1972138238 (323) 205-7088

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 9

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

MR. BENIGNO QUIRARTE M.S.
Marriage & Family Therapist
9265 SKY PARK CT STE 100
SAN DIEGO, CA 92123
San Diego County (844) 737-3638
SERENE HEALTH GROUP LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
9265 SKY PARK CT STE 100
SAN DIEGO, CA 92123
San Diego County (619) 455-1236
MISS LAUREN TAYLOR LOVE
Marriage & Family Therapist
9265 SKY PARK CT STE 100
SAN DIEGO, CA 92123
San Diego County (844) 737-3638
LAURENA PHAM LMFT
Marriage & Family Therapist
9265 SKY PARK CT STE 100
SAN DIEGO, CA 92123
San Diego County (844) 737-3638
VERONICA ORALIA MEDINA
Nurse Practitioner
9265 SKY PARK CT STE 100
SAN DIEGO, CA 92123
San Diego County (858) 355-9258
TYLER CZAK ASW
Social Worker (Clinical)
9265 SKY PARK CT STE 100
SAN DIEGO, CA 92123
San Diego County (702) 539-7001
JASMINE AVILEZ MA
Marriage & Family Therapist
9265 SKY PARK CT STE 100
SAN DIEGO, CA 92123
San Diego County (844) 737-3638
SERENE HEALTH
Counselor (Mental Health)
9265 SKY PARK CT STE 100
SAN DIEGO, CA 92123
San Diego County (844) 737-3638

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vanessa Icazbalceta-soto's NPI number?

The NPI number for Vanessa Icazbalceta-soto is 1083264519. It was assigned to this individual provider in the NPPES registry on September 17, 2019. The provider is also known as Vanessa Icazbalceta.

Where is Vanessa Icazbalceta-soto located?

Vanessa Icazbalceta-soto practices at 9265 Sky Park Ct Ste 100, San Diego, CA 92123. The listed phone number is (706) 524-7134.

What is Vanessa Icazbalceta-soto's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Vanessa Icazbalceta-soto enrolled in Medicare?

Yes. Vanessa Icazbalceta-soto is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Vanessa Icazbalceta-soto's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Vanessa Icazbalceta-soto reassigns Medicare benefits to 2 organizations: Serene Health (San Diego, CA) and Sud Specialty Group - Ca (Santa Clara, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Vanessa Icazbalceta-soto's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Vanessa Icazbalceta-soto was last updated on October 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.