NPIMap

Individual provider Active NPI

Jessica Lawrence

  • Clinical Social Worker
  • San Jose, CA
National Provider Identifier
1053704130
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
115792 Issued in CA
Practice address
6840 Via del Oro Ste 210
San Jose, CA 95119-1372
Phone
(408) 284-2280
NPI assigned
Mar 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Social Worker 104100000X 85949 CA
Clinical Social Worker 1041C0700X 115792 CA Primary

Addresses

Primary practice location

6840 Via del Oro Ste 210
San Jose, CA 95119-1372

Mailing address

6840 Via del Oro Ste 210
San Jose, CA 95119-1372
Phone (408) 284-2280

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
85949CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
School Health Clinics of Santa Clara County Past Accepting new patients
School Health Clinics of Santa Clara County Past Accepting new patients
School Health Clinics of Santa Clara County Past Accepting new patients
School Health Clinics of Santa Clara County Past Accepting new patients
School Health Clinics of Santa Clara County Past Accepting new patients

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": "1426118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1053704130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6840 VIA DEL ORO STE 210",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191372",
            "telephone_number": "408-284-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6840 VIA DEL ORO STE 210",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191372",
            "telephone_number": "408-284-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-12",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "85949",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "115792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.