Individual provider Active NPI

Barbra Jannet Jackson, LCSW

  • Clinical Social Worker
  • Chula Vista, CA
National Provider Identifier
1215359005
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
130326 Issued in CA
Practice address
1180 Third Ave Ste C3
Chula Vista, CA 91911-3139
Phone
(619) 691-8164
NPI assigned
Jan 13, 2014
Last updated
Jul 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 130326 CA Primary
Clinical Social Worker 1041C0700X ASW104854 CA

Addresses

Primary practice location

1180 Third Ave Ste C3
Chula Vista, CA 91911-3139

Mailing address

PO Box 2569
Everett, WA 98213-0569

Other practice location 1

7290 El Cajon Blvd
San Diego, CA 92115-1829
Phone (619) 906-5347

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
I20250821000941 CA Practitioner - Clinical Social Worker 7618477050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

823 Gateway Ctr Way
San Diego, CA 92102-4541

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
130326CAMDClinical Social Worker
ASW104854CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc. CurrentSince Jul 14, 2025 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Jul 14, 2025 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Family Health Centers of San Diego, Inc PastSince May 16, 2021 Accepting new patients
McAlister Institute for Treatment & Education, Inc. Clinical PastSince Oct 10, 2021 Accepting new patients

Locations

7290 El Cajon Blvd
San Diego, CA 92115
Phone (619) 255-7705

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1389571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1215359005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2569",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982130569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 THIRD AVE STE C3",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919113139",
            "telephone_number": "619-691-8164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7290 El Cajon Blvd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921151829",
            "country_code": "US",
            "telephone_number": "619-906-5347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BARBRA",
        "middle_name": "JANNET",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-13",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "130326",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW104854",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.