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SALLY PETERSON LCSW
NPI 1750838942
Social Worker - Clinical in San Diego, CA

Active since September 06, 2016Opted out of Medicare · through Jun 15, 2027
3160 CAMINO DEL RIO S, #304, SAN DIEGO, CA 92108(619) 819-0283(610) 819-0284 Get Directions Write a Review

NPPES record last updated: September 6, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sally Peterson Lcsw NPPES

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

SALLY PETERSON LCSW (NPI 1750838942) is an individual clinical provider in San Diego, California, licensed in California (LCSW20865) and active in the NPI registry since September 2016. She has opted out of Medicare through June 15, 2027.

NPPES Registry Identity

NPI1750838942
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSALLY PETERSONCredential: LCSW
Location Address3160 CAMINO DEL RIO S, #304San Diego, CA 92108-3813
Mailing Address3160 Camino Del Rio S, #304San Diego, CA 92108-3813 · (619) 819-0283 · Fax (610) 819-0284
Phone(619) 819-0283
Fax(610) 819-0284
Sole ProprietorYes
Enumeration DateSeptember 6, 2016
✔ NPI 1750838942 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 · LCSW20865
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.
3160 CAMINO DEL RIO S, San Diego, CA 92108
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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

Sally Peterson Lcsw 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 June 15, 2021 through June 15, 2027.

Opt-Out Effective DateJune 15, 2021
Opt-Out In Effect ThroughJune 15, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92108 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $62.10 – $184.71
Typical copayment $0.00 (range $15.52 – $46.17)
Most-billed visit code NA
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

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

DR. PRADEEP GIDWANI MD
Pediatrics
3160 CAMINO DEL RIO S, SUITE115
SAN DIEGO, CA 92108
San Diego County (619) 281-2291
MR. DANIEL CHONGMYUNG KIM
Marriage & Family Therapist
3160 CAMINO DEL RIO S, #304
SAN DIEGO, CA 92108
San Diego County (619) 819-0283
POTENTIA FAMILY THERAPY, INC.
Marriage & Family Therapist
3160 CAMINO DEL RIO S, 304
SAN DIEGO, CA 92108
San Diego County (619) 819-0283
KAYLA WALKER
Marriage & Family Therapist
3160 CAMINO DEL RIO S, SUITE 304
SAN DIEGO, CA 92108
San Diego County (619) 819-0283
TONIA MARIE FERGUSON
Marriage & Family Therapist
3160 CAMINO DEL RIO S
SAN DIEGO, CA 92108
San Diego County (619) 879-0025
SARAH BEIRUTY SB
Counselor (Mental Health)
3160 CAMINO DEL RIO S
SAN DIEGO, CA 92108
San Diego County (619) 352-0486
MIKAYLA JONES-LEWIS
Marriage & Family Therapist
3160 CAMINO DEL RIO S
SAN DIEGO, CA 92108
San Diego County (619) 352-0468
HEART BEAT MONITORING P.C.
Internal Medicine (Cardiovascular Disease)
3160 CAMINO DEL RIO S
SAN DIEGO, CA 92108
San Diego County (516) 872-7001

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 Sally Peterson's NPI number?

The NPI number for Sally Peterson is 1750838942. It was assigned to this individual provider in the NPPES registry on September 6, 2016.

Where is Sally Peterson located?

Sally Peterson practices at 3160 Camino Del Rio S #304, San Diego, CA 92108. The listed phone number is (619) 819-0283.

What is Sally Peterson's specialty?

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

Is Sally Peterson enrolled in Medicare?

No. Sally Peterson has opted out of Medicare through June 15, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Sally Peterson was last updated on September 6, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.