Individual provider Active NPI

Elizabeth De Jesus

  • Social Worker
  • Soledad, CA
National Provider Identifier
1053167767
Registry record updated Sep 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
ASW131985 Issued in CA
Practice address
31625 US-101
Soledad, CA 93960
Phone
(831) 678-5500
NPI assigned
Apr 24, 2024
Last updated
Sep 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X ASW131985 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

31625 US-101
Soledad, CA 93960

Mailing address

PO Box 920
Greenfield, CA 93927-0920
Phone (000) 000-0000

Other practice location 1

2945 McMillan Ave Ste 240
San Luis Obispo, CA 93401-6771
Phone (805) 439-4890

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

State licenses

LicenseStateTypeSpecialty
ASW131985CAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757203200000",
    "number": "1053167767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920",
            "city": "GREENFIELD",
            "state": "CA",
            "postal_code": "939270920",
            "telephone_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31625 US-101",
            "city": "SOLEDAD",
            "state": "CA",
            "postal_code": "93960",
            "telephone_number": "831-678-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2945 McMillan Ave Ste 240",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "934016771",
            "country_code": "US",
            "telephone_number": "805-439-4890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-24",
        "last_updated": "2025-09-07",
        "certification_date": "2025-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW131985",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soledad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2025; 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.