Individual provider Active NPI

Jessica Weeks, MSW

  • Clinical Social Worker
  • Elk Grove, CA
National Provider Identifier
1255058657
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ASW122927 Issued in CA
Practice address
9412 Big Horn Blvd Ste 6
Elk Grove, CA 95758-1101
Phone
(916) 712-5610
NPI assigned
Oct 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X ASW122927 CA Primary
Psychologist 103T00000X

Addresses

Primary practice location

9412 Big Horn Blvd Ste 6
Elk Grove, CA 95758-1101

Mailing address

9412 Big Horn Blvd Ste 6
Elk Grove, CA 95758-1101
Phone (916) 712-5610

Other identifiers 1

IdentifierTypeStateIssuer
171M00000XMedicaidCA

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

State licenses

LicenseStateTypeSpecialty
ASW122927CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1255058657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9412 BIG HORN BLVD STE 6",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957581101",
            "telephone_number": "916-712-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9412 BIG HORN BLVD STE 6",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957581101",
            "telephone_number": "916-712-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEEKS",
        "first_name": "JESSICA",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-26",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW122927",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171M00000X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.