Johanna Jefferies, LCSW #108766

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

108766 Issued in CA

Practice address

1400 Emeline Ave
Santa Cruz, CA 95060-1976

Phone

(831) 454-4170

Fax

(831) 454-4484

NPI assigned

Oct 24, 2016

Last updated

Aug 29, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of Santa CruzGroup PAC ID 7618872912, 65 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• County of Santa Cruz

  • Clinic/Center
  • Santa Cruz, CA
  • NPI 1659315430
  Medicare reassignment Care Compare group NPD
• County of Santa Cruz

  dba Watsonville Health Center

  • Federally Qualified Health Center (FQHC)
  • Watsonville, CA
  • NPI 1770709149
  NPD

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1225589393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 TYLER CT",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651356",
            "telephone_number": "183-332-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601976",
            "telephone_number": "831-454-4170",
            "fax_number": "831-454-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERIES",
        "first_name": "JOHANNA",
        "credential": "LCSW #108766",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-24",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "108766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay Pennock Medical Director PC (Rejuvenate Vitamin Shot and IV Clinic)
• JD Group
• JD Group
• Jeannine M. Rodems, MD Inc (Santa Cruz Direct Primary Care)
• Jennifer Jeffcoat, CST, PPN-P, PPN-E
• Leilani Jefferies, L.C.S.W.
• Laura Jefferson
• Brian Michael Jenkins, PA-C
• Kalonia Jennings
• Kaitlin Jensen

• Clinical Social Worker in Santa Cruz, CA
• Providers in Santa Cruz, 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 Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.