Sydney Nanyamka Dean-Jessie

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

68131 Issued in TX

Practice address

306 E Randol Mill Rd Ste 300
Arlington, TX 76011-5839

Phone

(844) 824-8775

NPI assigned

Sep 6, 2018

Last updated

Nov 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Shine Medical Providers PC

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1538894050
  NPD (past)

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1245713189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16782 VON KARMAN AVE STE 11",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926062417",
            "telephone_number": "855-223-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E RANDOL MILL RD STE 300",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760115839",
            "telephone_number": "844-824-8775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1855 2nd St Ste B",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "CA",
            "postal_code": "945192623",
            "country_code": "US",
            "telephone_number": "855-223-7123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEAN-JESSIE",
        "first_name": "SYDNEY",
        "middle_name": "NANYAMKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-06",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "68131",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-18-64562",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karrah Black De la Fuente, PA
• Aaron Jouston De Leon, MSN, APRN, FNP-BC
• Darlenis De Los Santos
• Marcel De Oliveira, PTA
• De White Imperial Global LLC
• Shelby Tiffany Debord, LCSW
• Christina Suzanne Decaro, FNP-BC
• Deck Scott Holdings LLC (Classic Transportation)
• Meredith Decker
• Ashley Deege

• Clinical Social Worker in Arlington, TX
• Providers in Arlington, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.