Individual provider Active NPI

Jena Nguyen, LCSW

  • Clinical Social Worker
  • Garden Grove, CA
National Provider Identifier
1134402175
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
68702 Issued in CA
Practice address
12141 Brookhurst St Ste 101
Garden Grove, CA 92840-2865
Phone
(714) 296-1934
NPI assigned
Sep 26, 2011
Last updated
Mar 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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 68702 CA Primary

Addresses

Primary practice location

12141 Brookhurst St Ste 101
Garden Grove, CA 92840-2865

Mailing address

12141 Brookhurst St Ste 101
Garden Grove, CA 92840-2865

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
I20250327002159 CA Practitioner - Clinical Social Worker 7517480833 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
68702CAMDOncology Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Telecare Corporation CurrentSince Mar 1, 2025 Accepting new patients
Telecare Corporation CurrentSince Mar 11, 2025 Accepting new patients
Telecare Corporation Current Accepting new patients
New Alternatives Inc. PastSince Oct 1, 2019 Accepting new patients

Locations

1080 Marina Village Pkwy
Ste 100
Alameda, CA 94501
Phone (510) 306-5660

12141 Brookhurst St
Garden Grove, CA 92840
Phone (714) 296-1934

12141 Brookhurst St
Ste 101
Garden Grove, CA 92840
Phone (714) 296-1934

2100 N Broadway
Ste 101
Santa Ana, CA 92706
Phone (714) 245-6881

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1134402175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12141 BROOKHURST ST STE 101",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928402865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12141 BROOKHURST ST STE 101",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928402865",
            "telephone_number": "714-296-1934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JENA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-26",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "68702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.