Mary Virginia Jeffries, MSW

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

License

ASW12041 Issued in CA

Practice address

11565 Laurel Canyon Blvd
#100
San Fernando, CA 91340-4168

Phone

(818) 365-4723

Fax

(818) 365-3475

NPI assigned

Mar 14, 2007

Sex

Female

Sole proprietor

No

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)

Not enrolled

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.

• San Fernando Valley Community Mental Health Center, Inc.

  • Psychiatry Physician
  • San Fernando, CA
  • NPI 1841320793
  NPD (past)

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114051281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 N MAR VISTA AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911061127",
            "telephone_number": "626-793-9226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11565 LAUREL CANYON BLVD",
            "address_2": "#100",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913404168",
            "telephone_number": "818-365-4723",
            "fax_number": "818-365-3475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFRIES",
        "first_name": "MARY",
        "middle_name": "VIRGINIA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": "ASW12041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marina Janzer
• Beatriz Jaramillo
• Edith Jauregui
• Rita Elvira Jauregui
• Javier Jara DDS Inc.
• Jerry B Malleus, DDS Inc.
• Maria Avalos Jimenez, LVN
• Richard Keith John Jr.
• Gina Marie Johnson, M.D.
• Grady Patrick Johnson

• Rehabilitation Practitioner in San Fernando, CA
• Providers in San Fernando, CA by specialty
• Rehabilitation Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.