Derek Scott Jensen, MSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

ASW75927 Issued in CA

Practice address

2122 S El Camino Real Ste 102
Oceanside, CA 92054-6209

Phone

(760) 290-8170

Fax

(760) 439-0019

NPI assigned

Jun 6, 2018

Last updated

Jun 6, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1295227031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 S EL CAMINO REAL STE 102",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546209",
            "telephone_number": "760-290-8170",
            "fax_number": "760-439-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 S EL CAMINO REAL STE 102",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546209",
            "telephone_number": "760-290-8170",
            "fax_number": "760-439-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "DEREK",
        "middle_name": "SCOTT",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW75927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jbi Wellness, LLC (Oceanside Mental Health)
• Kam Jebreil, DMD
• Sarah Jebreil, DDS
• Jenavieve Donnelly Counseling Services LLC
• Derek Michael Jensen, IDC
• Haylen Rae Jensen
• Kori Jensen
• Jerald D. White, MD, AMC
• Jeremy L Walker Dental Corporation
• Jeremy Walker DMD Corporation

• Mental Health Counselor in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.