Jennifer Michelle Blum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

126754 Issued in CA

Practice address

300 Rancheros Dr Ste 130
San Marcos, CA 92069-2968

Phone

(858) 279-1223

NPI assigned

May 8, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Jennifer Michelle Warawa Former name

Medicare fee-for-service enrollment

Enrolled in KY, CA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Fusion Care Group, a Psychological Professional Corporation

  • Clinical Psychologist
  • Alpine, CA
  • NPI 1275177982
  Medicare reassignment NPD
• Heartwood Therapy Place LLC

  • Social Worker
  • Louisville, KY
  • NPI 1285272088

  Clinical

  Medicare reassignment NPD
• Kentucky Counseling Center, LLC

  • Counselor
  • Louisville, KY
  • NPI 1932590338
  Medicare reassignment NPD

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1063901775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 RANCHEROS DR STE 130",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692968",
            "telephone_number": "858-279-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RANCHEROS DR STE 130",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692968",
            "telephone_number": "858-279-1223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1941 Bishop Ln Ste 1019",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402181928",
            "country_code": "US",
            "telephone_number": "502-851-6384",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5201 Great America Pkwy Ste 320",
            "address_purpose": "LOCATION",
            "city": "Santa Clara",
            "state": "CA",
            "postal_code": "950541140",
            "country_code": "US",
            "telephone_number": "323-205-7088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2271 Alpine Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Alpine",
            "state": "CA",
            "postal_code": "919011101",
            "country_code": "US",
            "telephone_number": "888-688-0248",
            "fax_number": "888-291-4799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUM",
        "first_name": "JENNIFER",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "253264",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "126754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WARAWA",
            "middle_name": "MICHELLE",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Douglas A Blaney, PT
• Kathleen Carol Blattner, N.P.
• BLC-Brookdale Place of San Marcos, L.P.
• Megan Block
• Natalie Blue
• Lorraine Michelle Bock
• Laura Ann Bodrogi, LVN
• Kyung Lee Boen, DMD
• Ivana Bogovac
• David Steele Bohline, PHD

• Clinical Social Worker in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.