Individual provider Active NPI

Jasmine A Vasquez, LCSW

  • Clinical Social Worker
  • Arcadia, CA
National Provider Identifier
1093002859
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
81894 Issued in CA
Practice address
440 E Huntington Dr Ste 300
Arcadia, CA 91006-3775
Phone
(626) 515-4202
NPI assigned
Jun 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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 81894 CA Primary

Addresses

Primary practice location

440 E Huntington Dr Ste 300
Arcadia, CA 91006-3775

Mailing address

440 E Huntington Dr Ste 300
Arcadia, CA 91006-3775
Phone (626) 515-4202

Other practice location 1

1111 W Covina Blvd Ste 110
San Dimas, CA 91773-3205
Phone (626) 515-4202

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
I20200513000745 CA Practitioner - Clinical Social Worker 1850722521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
81894CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Selah Counseling Center, a Licensed Clinical Social Worker Corporation Clinical Current Accepting new patients
Abundance Psychotherapy Center Inc Clinical CurrentSince Apr 9, 2020 Accepting new patients
Enriched Life Therapy Center Clinical Past Accepting new patients

Locations

440 E Huntington Dr
Ste 360
Arcadia, CA 91006
Phone (626) 684-3300

440 E Huntington Dr
Ste 300
Arcadia, CA 91006
Phone (626) 230-4094

4221 Wilshire Blvd
Ste 170-16
Los Angeles, CA 90010
Phone (213) 441-6780

4221 Wilshire Blvd
Ste 290-26
Los Angeles, CA 90010
Phone (213) 441-6780

1111 W Covina Blvd
Ste 110
San Dimas, CA 91773
Phone (626) 515-4202

Organizations & group practices 3

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": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1093002859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 E HUNTINGTON DR STE 300",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063775",
            "telephone_number": "626-515-4202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 E HUNTINGTON DR STE 300",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063775",
            "telephone_number": "626-515-4202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 W Covina Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "San Dimas",
            "state": "CA",
            "postal_code": "917733205",
            "country_code": "US",
            "telephone_number": "626-515-4202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "JASMINE",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "81894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.