Jacquelyn Summers, PH.D., MPH, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW17167 Issued in CA

Practice address

915 I Ave
Coronado, CA 92118-2449

Phone

(619) 446-9631

NPI assigned

Dec 27, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Robert Zalewski-Zaragoza, MD, Inc

  • Psychiatry Physician
  • San Diego, CA
  • NPI 1366857476
  NPD (past)

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

{
    "created_epoch": "1482796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482883200000",
    "number": "1104361203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 181171",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921781171",
            "telephone_number": "619-446-9631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 I AVE",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921182449",
            "telephone_number": "619-446-9631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "JACQUELYN",
        "name_prefix": "Dr.",
        "credential": "PH.D., MPH, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-27",
        "last_updated": "2016-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW17167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen H Dao DDS PC
• Stephen J Moffett OD a Professional
• Paula Stonehouse
• Strength in Service
• Strength in Service
• Stephen Sun, DO
• Suzanne M. M. Popp, DDS, Inc
• Svetlana Gentry, NP
• Rachel Tansiongco Swimmer, DMD
• Leonard Sydnor

• Clinical Social Worker in Coronado, CA
• Providers in Coronado, 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 Dec 28, 2016; 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.