Individual provider Active NPI

Jean Louise Hebert-Brown, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1205808763
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 9682 Issued in CA
Practice address
3633 Camino del Rio S 102
San Diego, CA 92108-4012
Phone
(619) 260-8028
Fax
(619) 260-1036
NPI assigned
Feb 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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 LCS 9682 CA Primary

Addresses

Primary practice location

3633 Camino del Rio S 102
San Diego, CA 92108-4012

Mailing address

3633 Camino del Rio S 102
San Diego, CA 92108-4012
Phone (619) 260-8028

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
I20101102000235 CA Practitioner - Clinical Social Worker 4587858782 Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3633 Camino del Rio S
Suite 102
San Diego, CA 92108-4012
Phone (619) 260-8028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9682CAMDProfessional Counselor
LCS 9682CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Joanna R Benavidez PHD Clinical Psychologist PastSince Jul 1, 2020 Accepting new patients
Jeanne M. Peterson, PH.D., Psychologist, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1205808763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 CAMINO DEL RIO S 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084012",
            "telephone_number": "619-260-8028",
            "fax_number": "619-260-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 CAMINO DEL RIO S 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084012",
            "telephone_number": "619-260-8028",
            "fax_number": "619-260-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBERT-BROWN",
        "first_name": "JEAN",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 9682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.