Individual provider Active NPI

Vesna Jurlin - Jevtic, MSW

  • Clinical Social Worker
  • San Jose, CA
National Provider Identifier
1306976378
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ASW 19209 Issued in CA
Practice address
2221 Enborg LN
San Jose, CA 95128-2608
Phone
(408) 885-6220
Fax
(408) 885-3977
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ASW 19209 CA Primary

Addresses

Primary practice location

2221 Enborg LN
San Jose, CA 95128-2608

Mailing address

2221 Enborg LN
San Jose, CA 95128-2608
Phone (408) 885-6220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130208000369 CA Practitioner - Clinical Social Worker 6204080773 Reassigns benefits to 1 organization
I20151118001848 CA Practitioner - Clinical Social Worker 6204080773 Practice locations: Sunnyvale, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

830 Stewart Dr
Sunnyvale, CA 94085-4513
Phone (408) 656-2757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW 19209CAMDClinical Social Worker
26465CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Aug 18, 2018 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Aug 18, 2018 Accepting new patients

Locations

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

2221 Enborg Ln
San Jose, CA 95128
Phone (408) 885-6220

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Organizations & group practices 3

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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306976378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 ENBORG LN",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282608",
            "telephone_number": "408-885-6220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 ENBORG LN",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282608",
            "telephone_number": "408-885-6220",
            "fax_number": "408-885-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURLIN - JEVTIC",
        "first_name": "VESNA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW 19209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.