Jennifer Parker Hackett

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13343 Issued in SC

Practice address

11201 Benton St
Loma Linda, CA 92357-4238

Phone

(909) 825-7084

NPI assigned

Jul 28, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer Parker Aylworth Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1235682089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10259 STAFFORD ST",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303045",
            "telephone_number": "951-836-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 BENTON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923574238",
            "telephone_number": "909-825-7084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1556 S Sultana Ave",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "CA",
            "postal_code": "917614238",
            "country_code": "US",
            "telephone_number": "909-418-6923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HACKETT",
        "first_name": "JENNIFER",
        "middle_name": "PARKER",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-28",
        "last_updated": "2019-10-10",
        "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": "SC",
            "license": "13343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "AYLWORTH",
            "middle_name": "PARKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joshua Travis Gysbers, PA-C
• Euntaik Ha, M.D.
• Xuanphung Thi Ha, R.PH.
• Tyler Haase, MD
• Victoria Serine Haase
• Janet E Hackleman, RN, MFT
• Victoria Haddad Riddle, DPT
• Rami Haddad, D.O.
• Henry Roger Hadley, M.D.
• Tiffany Chih-Shan Lo Hadley

• Clinical Social Worker in Loma Linda, CA
• Providers in Loma Linda, 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 Oct 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.