Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Sergio A Ibanez, CM

Individual provider Clinical Social Worker · NPI 1972021152

Sergio A Ibanez, CM is a Clinical Social Worker in San Diego, California. Qualified in 2019, 7 years ago. Practices with Sud Specialty Group - Ca, a 499-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
7
Licensed in
CA
In the registry since
2017
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Practice location Address checks out

4361 Newton Ave
San Diego, CA 92113-3430
Phone: (760) 505-5366
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 114575 (CA)

Record details

NPI number1972021152
Entity typeIndividual (Type 1)
GenderMale
Credentials CM
Sole proprietorNo
NPI enumeratedSeptember 7, 2017
Last updated in NPPESMarch 19, 2025
Certification dateMarch 19, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Sud Specialty Group - Ca — 499 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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