=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225396419
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARA SHAREE NIEMEIER M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2012
-----------------------------------------------------
Last Update Date | 01/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4660 LA JOLLA VILLAGE DR STE 100
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92122-4604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-752-0765
-----------------------------------------------------
Fax | 858-356-6252
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 122 15TH ST UNIT 2683
-----------------------------------------------------
City | DEL MAR
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92014-8087
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-752-0765
-----------------------------------------------------
Fax | 858-356-9611
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | DR.0057423
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | A146882
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | MD173121
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------