Individual provider Active NPI

Jessica Nicole Mosqueda, LMSW

  • Clinical Social Worker
  • Leavenworth, KS
National Provider Identifier
1285120147
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
132399 Issued in CA
Practice address
4101 S 4TH St
Leavenworth, KS 66048-5014
Phone
(913) 682-2000
NPI assigned
Jul 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2015040913 MO
Clinical Social Worker 1041C0700X 132399 CA Primary
Social Worker 104100000X 9552 KS

Addresses

Primary practice location

4101 S 4TH St
Leavenworth, KS 66048-5014

Mailing address

1630 Velum CT
Beaumont, CA 92223-3210
Phone (785) 249-6837

Other names 1

  • Jessica Nicole Mosqueda Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260605002271 CA Practitioner - Clinical Social Worker 5991276347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1630 Velum CT
Beaumont, CA 92223-3210

500 Westover Dr
Suite 13619
sanford, NC 27330-8941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9552KSMDSocial Worker
2015040913MOMDSocial Worker
132399CAMDClinical Social Worker

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1285120147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 VELUM CT",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922233210",
            "telephone_number": "785-249-6837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 S 4TH ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660485014",
            "telephone_number": "913-682-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSQUEDA",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2015040913",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "132399",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "9552",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MOSQUEDA",
            "middle_name": "NICOLE",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Leavenworth, KS

Sources for this page

Verify at the official NPI Registry.