Jacqueline Daphnee Surpin

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

126551 Issued in CA

Practice address

5201 Great America Pkwy
Santa Clara, CA 95054-1122

Phone

(323) 205-7088

NPI assigned

Jul 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1164908554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 MEDICAL CENTER CT",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919116618",
            "telephone_number": "619-863-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 GREAT AMERICA PKWY",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950541122",
            "telephone_number": "323-205-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURPIN",
        "first_name": "JACQUELINE",
        "middle_name": "DAPHNEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "126551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Younjoo Sung
• Sunshine Acupuncture & Healthcare
• Sunshine Holistic Wellness Center LLC
• Surgical and Trauma Services
• Surgical Assist Services Inc
• Santa B. Suryaraman, MD
• Neil Sutaria, MA CCC-SLP
• Sutter Bay Medical Foundation
• Sutter Bay Medical Foundation
• Suzanna Freerksen, MD, Inc.

• Clinical Social Worker in Santa Clara, CA
• Providers in Santa Clara, 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 Jan 29, 2025; 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.