Individual provider Active NPI

Jacqueline D Jauregui

  • Clinical Social Worker
  • Santa Fe Springs, CA
National Provider Identifier
1023519253
Registry record updated Mar 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW128746 Issued in CA
Practice address
11731 Telegraph Rd Ste K
Santa Fe Springs, CA 90670-6815
Phone
(562) 907-7429
NPI assigned
Feb 22, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW80167 CA
Social Worker 104100000X ASW118734 CA
Clinical Social Worker 1041C0700X LCSW128746 CA Primary

Addresses

Primary practice location

11731 Telegraph Rd Ste K
Santa Fe Springs, CA 90670-6815

Mailing address

9533 San Juan Ave
South Gate, CA 90280-4735
Phone (213) 399-9048

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251125004021 CA Practitioner - Clinical Social Worker 0749772838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11731 Telegraph Rd
Santa Fe Springs, CA 90670-3675

800 S Santa Anita Ave
Arcadia, CA 91006-3536

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW80167CAMDMental Health Counselor
ASW118734CAMDSocial Worker
LCSW128746CAMDClinical Social Worker
128746CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Clinics CurrentSince Sep 9, 2025 Accepting new patients
Pacific Clinics Current Accepting new patients
Pacific Clinics CurrentSince Sep 9, 2025 Accepting new patients
Pacific Clinics Past Accepting new patients

Locations

251 Llewellyn Ave
Campbell, CA 95008
Phone (408) 364-4083

1020 S Arroyo Pkwy
Pasadena, CA 91105
Phone (626) 403-2794

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741392000000",
    "number": "1023519253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9533 SAN JUAN AVE",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902804735",
            "telephone_number": "213-399-9048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11731 TELEGRAPH RD STE K",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906706815",
            "telephone_number": "562-907-7429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAUREGUI",
        "first_name": "JACQUELINE",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-22",
        "last_updated": "2025-03-08",
        "certification_date": "2025-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW80167",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW118734",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW128746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe Springs, CA

Sources for this page

Verify at the official NPI Registry.