Individual provider Active NPI

Jaime K Nunnenkamp

  • Clinical Social Worker
  • Lancaster, CA
National Provider Identifier
1033439625
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW75898 Issued in CA
Practice address
921 W Avenue J
Suite C
Lancaster, CA 93534-3443
Phone
(661) 949-0131
Fax
(661) 729-8912
NPI assigned
Jun 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW34333 CA
Clinical Social Worker 1041C0700X LCSW75898 CA Primary

Addresses

Primary practice location

921 W Avenue J
Suite C
Lancaster, CA 93534-3443

Mailing address

921 W Avenue J
Suite C
Lancaster, CA 93534-3443
Phone (661) 949-0131

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
I20250930004547 CA Practitioner - Clinical Social Worker 6002312956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3633 E Broadway
Long Beach, CA 90803-6035

506 W Jackman St
Lancaster, CA 93534-2531

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW34333CAMDMental Health Counselor
LCSW75898CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health America of Los Angeles CurrentSince Sep 12, 2025 Accepting new patients
Mental Health America of Los Angeles CurrentSince Sep 12, 2025 Accepting new patients
Mental Health America of Los Angeles Current Accepting new patients
All for Kids Organization PastSince Dec 21, 2025 Accepting new patients

Locations

506 W Jackman St
Lancaster, CA 93534
Phone (661) 947-1595

1955 Long Beach Blvd
Long Beach, CA 90806
Phone (562) 533-4942

Organizations & group practices 5

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": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1033439625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 W AVENUE J",
            "address_2": "SUITE C",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935343443",
            "telephone_number": "661-949-0131",
            "fax_number": "661-729-8912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 W AVENUE J",
            "address_2": "SUITE C",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935343443",
            "telephone_number": "661-949-0131",
            "fax_number": "661-729-8912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNNENKAMP",
        "first_name": "JAIME",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-04",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW34333",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW75898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.