Individual provider Active NPI

Ciarys Rubio Jung

  • Clinical Social Worker
  • Cedar Park, TX
National Provider Identifier
1215690516
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
103995 Issued in CA
Practice address
3440 Ranch TRL Apt 2423
Cedar Park, TX 78613-2445
Phone
(323) 366-9561
NPI assigned
Oct 14, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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 109807 TX
Clinical Social Worker 1041C0700X 103995 CA Primary

Addresses

Primary practice location

3440 Ranch TRL Apt 2423
Cedar Park, TX 78613-2445

Mailing address

3440 Ranch TRL Apt 2423
Cedar Park, TX 78613-2445

Other practice location 1

1516 S Downey Rd
Los Angeles, CA 90023-4043
Phone (323) 366-9561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230308001521 CA Practitioner - Clinical Social Worker 6002289212 Reassigns benefits to 1 organization
I20230911003417 TX Practitioner - Clinical Social Worker 6002289212 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109807TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alta Therapy Center PLLC CurrentSince Feb 19, 2023 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Aug 1, 2023 Accepting new patients
Grow Healthcare Group PC Clinical CurrentSince Feb 16, 2023 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

Organizations & group practices 3

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": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1215690516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 RANCH TRL APT 2423",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 RANCH TRL APT 2423",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132445",
            "telephone_number": "323-366-9561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1516 S Downey Rd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900234043",
            "country_code": "US",
            "telephone_number": "323-366-9561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUNG",
        "first_name": "CIARYS",
        "middle_name": "RUBIO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "109807",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "103995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

Verify at the official NPI Registry.