Kailah Joy Dejurnett, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW94205 Issued in CA

Practice address

13768 Roswell Ave Ste 220
Chino, CA 91710-1408

Phone

(909) 497-7288

NPI assigned

Jun 19, 2015

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

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": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1255713822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8549 WILSHIRE BLVD # 2187",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113104",
            "telephone_number": "520-237-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13768 ROSWELL AVE STE 220",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917101408",
            "telephone_number": "909-497-7288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22320 Yorke Rd",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925532040",
            "country_code": "US",
            "telephone_number": "951-255-2679",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8485 E. 22nd Street Apt 108",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857102040",
            "country_code": "US",
            "telephone_number": "951-255-2679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEJURNETT",
        "first_name": "KAILAH",
        "middle_name": "JOY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW94205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Chino, CA
• Providers in Chino, 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 Mar 24, 2021; 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.