Individual provider Active NPI

Claudia F Jesus de Sepe, LCSW

  • Clinical Social Worker
  • Santa Ana, CA
National Provider Identifier
1184057655
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104504 Issued in CA
Practice address
3611 S. Harbor Blvd.
Suite 100
Santa Ana, CA 92704
Phone
(909) 251-9352
NPI assigned
Aug 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 104504 CA Primary

Addresses

Primary practice location

3611 S. Harbor Blvd.
Suite 100
Santa Ana, CA 92704

Mailing address

PO Box 1612
Fontana, CA 92334-1612

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
I20241017001171 CA Practitioner - Clinical Social Worker 9436681277 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spring to Autumn Family Counseling, Inc. CurrentSince Oct 8, 2024 Accepting new patients

Locations

1275 W Park Ave
#7461
Redlands, CA 92373

2068 Orange Tree Ln
Ste 216
Redlands, CA 92374
Phone (909) 553-0448

11870 Pierce St
Ste 150
Riverside, CA 92505
Phone (909) 557-6574

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1184057655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1612",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923341612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 S. HARBOR BLVD.",
            "address_2": "SUITE 100",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92704",
            "telephone_number": "909-251-9352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESUS DE SEPE",
        "first_name": "CLAUDIA",
        "middle_name": "F",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-19",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "104504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.