Individual provider Active NPI

Jessica Troncoso, LCSW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1114342789
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-10519 Issued in NM
Practice address
6121 Indian School Rd NE Ste 141
Albuquerque, NM 87110-3176
Phone
(505) 888-1362
NPI assigned
Feb 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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 C-10519 NM Primary

Addresses

Primary practice location

6121 Indian School Rd NE Ste 141
Albuquerque, NM 87110-3176

Mailing address

6244 Canario CT NW
Albuquerque, NM 87120-2044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C-10519NMMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1114342789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6244 CANARIO CT NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871202044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 INDIAN SCHOOL RD NE STE 141",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103176",
            "telephone_number": "505-888-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRONCOSO",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-19",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-10519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; 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.