Individual provider Active NPI

Jessica Elyse Fetner, B.S.W.

  • Social Worker
  • San Juan Capistrano, CA
National Provider Identifier
1245547819
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
26891 Spring St
San Juan Capistrano, CA 92675-2692
Phone
(949) 496-2931
NPI assigned
Sep 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X CA Primary

Addresses

Primary practice location

26891 Spring St
San Juan Capistrano, CA 92675-2692

Mailing address

34816 Calle del Sol
Capistrano Beach, CA 92624-1553
Phone (949) 291-6271

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1245547819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34816 CALLE DEL SOL",
            "city": "CAPISTRANO BEACH",
            "state": "CA",
            "postal_code": "926241553",
            "telephone_number": "949-291-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26891 SPRING ST",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926752692",
            "telephone_number": "949-496-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETNER",
        "first_name": "JESSICA",
        "middle_name": "ELYSE",
        "credential": "B.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-02",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan Capistrano, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; 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.