Jessica Cypress Immitt, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

75900 Issued in CA

Practice address

808 E St
Eureka, CA 95501-1856

Phone

(707) 498-3809

NPI assigned

Jan 26, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

County of HumboldtGroup PAC ID 4082516950, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Humboldt

  • State or Local Public Health Clinic/Center
  • Eureka, CA
  • NPI 1871676213
  Medicare reassignment Care Compare group NPD
• County of Humboldt

  • Community/Behavioral Health Agency
  • Eureka, CA
  • NPI 1033300306
  NPD
• County of Humboldt

  • Clinical Medical Laboratory
  • Eureka, CA
  • NPI 1689751687
  NPD

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1013213842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 E ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011856",
            "telephone_number": "707-498-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 E ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011856",
            "telephone_number": "707-498-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMMITT",
        "first_name": "JESSICA",
        "middle_name": "CYPRESS",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-26",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "75900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcie Lee Hyatt
• Ijeoma Stella Ihekwoeme, RPH
• Alyssa Ihle
• Bertha M Ilongo, NP
• Jason Imig
• Jonathan Joseph Iocco, RN
• John Walter Irvine, MD
• Caroline Isaacs, MFT
• Allison Isaacson
• Donald J Iverson, MD

• Clinical Social Worker in Eureka, CA
• Providers in Eureka, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.