Dominique Mon Drielle Jefferson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ASW129446 Issued in CA

Practice address

2640 Industry Way
Lynwood, CA 90262-4284

Phone

(310) 627-4525

NPI assigned

Mar 22, 2018

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": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1306340450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 INDUSTRY WAY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624284",
            "telephone_number": "310-627-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 INDUSTRY WAY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624284",
            "telephone_number": "310-627-4525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1841 W Imperial Hwy",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900475021",
            "country_code": "US",
            "telephone_number": "323-750-2850",
            "fax_number": "323-750-0851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "DOMINIQUE",
        "middle_name": "MON DRIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-22",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW129446",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Jara Alvarez
• Joanna Vanessa Jaramillo
• Emon Javadi, MD
• Arshdeep Singh Jawandha, M.B.,B.S.
• Saeed Jazayeri, PT, DPT, OCS, FAAOMP
• Frances Jennings
• Jerry L Lanier DDS Inc.
• Rubina Jetley
• Neha Jha, DO
• Carolina Jimenez

• Clinical Social Worker in Lynwood, CA
• Providers in Lynwood, 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 Jun 3, 2025; 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.