Jennifer Moynihan, Licensed Clinical Social Worker, Inc.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

JENNIFER MOYNIHAN, LICENSED CLINICAL SOCIAL WORKER, INC.

Practice address

9815 Carroll Canyon Rd Ste 101
San Diego, CA 92131-1123

Phone

(858) 284-0336

NPI assigned

May 31, 2023

Organization subpart

No

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

Authorized official

Name

Jennifer Leigh MoynihanNPI 1538187638

Title

Chief Executive Officer

Phone

(858) 284-0336

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Moynihan

  • Clinical Social Worker
  • San Diego, CA
  • NPI 1538187638
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1164115507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9815 CARROLL CANYON RD STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311123",
            "telephone_number": "858-284-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9815 CARROLL CANYON RD STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311123",
            "telephone_number": "858-284-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER MOYNIHAN, LICENSED CLINICAL SOCIAL WORKER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "MOYNIHAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "858-284-0336"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jennifer Trang Xa, D.D.S, Inc.
• Mary Rachel Jennings-Mull
• Alina Jennings

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, 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 May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.