Individual provider Active NPI

Jessica May Prisk

  • Clinical Social Worker
  • Chico, CA
National Provider Identifier
1154673754
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
93129 Issued in CA
Practice address
341 Broadway St Ste 412
Chico, CA 95928-5343
Phone
(530) 282-5151
NPI assigned
Oct 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 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 93129 CA Primary

Addresses

Primary practice location

341 Broadway St Ste 412
Chico, CA 95928-5343

Mailing address

341 Broadway St Ste 412
Chico, CA 95928-5343
Phone (530) 282-5151

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
93129CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1154673754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 BROADWAY ST STE 412",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959285343",
            "telephone_number": "530-282-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 BROADWAY ST STE 412",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959285343",
            "telephone_number": "530-282-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRISK",
        "first_name": "JESSICA",
        "middle_name": "MAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-05",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "93129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.