Individual provider Active NPI

Evelina Jaime, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1003062746
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS13639 Issued in CA
Practice address
286 Euclid Ave
Suite 102
San Diego, CA 92114-3610
Phone
(619) 266-2111
Fax
(619) 266-0496
NPI assigned
Aug 13, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS13639 CA Primary

Addresses

Primary practice location

286 Euclid Ave
Suite 102
San Diego, CA 92114-3610

Mailing address

286 Euclid Ave
Suite 102
San Diego, CA 92114-3610
Phone (619) 266-2111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218585600000",
    "number": "1003062746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 EUCLID AVE",
            "address_2": "SUITE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921143610",
            "telephone_number": "619-266-2111",
            "fax_number": "619-266-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 EUCLID AVE",
            "address_2": "SUITE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921143610",
            "telephone_number": "619-266-2111",
            "fax_number": "619-266-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIME",
        "first_name": "EVELINA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2008-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS13639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.