Active NPI
Trisha Jackson
- Social Worker
- Orange, CA
National Provider Identifier
1003118878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 1201 W la Veta Ave
Orange, CA 92868-4203 - Phone
- (714) 509-8521
- NPI assigned
- Nov 29, 2010
- Last updated
- Oct 11, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | NU | Primary | |
| Rehabilitation Practitioner | 225400000X | NU |
Addresses
Primary practice location
1201 W la Veta Ave
Orange, CA 92868-4203
Mailing address
4740 Warner Ave Apt 101
Huntington Beach, CA 92649-3999
Phone (702) 378-6603
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728604800000",
"number": "1003118878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4740 WARNER AVE APT 101",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926493999",
"telephone_number": "702-378-6603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 W LA VETA AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684203",
"telephone_number": "714-509-8521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "TRISHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-29",
"last_updated": "2024-10-11",
"certification_date": "2024-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.