Active NPI
Jennifer Simon, LCSW
- Clinical Social Worker
- Oakland, CA
National Provider Identifier
1093187486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW65973
- Practice address
- 2940 Summit St Ste 2C
Oakland, CA 94609-3416 - Phone
- (510) 671-8186
- NPI assigned
- Oct 23, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW65973 | CA | Primary |
Addresses
Primary practice location
2940 Summit St Ste 2C
Oakland, CA 94609-3416
Mailing address
2940 Summit Street
Suite 2C
Oakland, CA 94609
Phone (510) 671-8186
Other practice location 1
2940 Summit Street
Suite 2C
Oakland, CA 94609
Phone (510) 671-8186
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2025 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW65973 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600819200000",
"number": "1093187486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2940 SUMMIT STREET",
"address_2": "SUITE 2C",
"city": "OAKLAND",
"state": "CA",
"postal_code": "94609",
"telephone_number": "510-671-8186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2940 SUMMIT ST STE 2C",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093416",
"telephone_number": "510-671-8186"
}
],
"practiceLocations": [
{
"address_1": "2940 Summit Street",
"address_2": "Suite 2C",
"address_purpose": "LOCATION",
"city": "Oakland",
"state": "CA",
"postal_code": "94609",
"country_code": "US",
"telephone_number": "510-671-8186",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SIMON",
"first_name": "JENNIFER",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-23",
"last_updated": "2020-09-23",
"certification_date": "2020-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW65973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.