Individual provider Active NPI

Jessica Antonia Chandler

  • Clinical Social Worker
  • Moreno Valley, CA
National Provider Identifier
1053295717
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ASW101057 Issued in CA
Practice address
22630 Moralia Dr
Moreno Valley, CA 92557-2675
Phone
(323) 632-2903
NPI assigned
Aug 4, 2025
Last updated
Aug 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ASW101057 CA Primary

Addresses

Primary practice location

22630 Moralia Dr
Moreno Valley, CA 92557-2675

Mailing address

22630 Moralia Dr
Moreno Valley, CA 92557-2675
Phone (323) 632-2903

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
ASW101057CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1754265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1053295717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22630 MORALIA DR",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925572675",
            "telephone_number": "323-632-2903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22630 MORALIA DR",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925572675",
            "telephone_number": "323-632-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "JESSICA",
        "middle_name": "ANTONIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-04",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW101057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.