Jed E. Shafer, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS9580 Issued in CA

Practice address

855 N Euclid Ave
Ontario, CA 91762-2762

Phone

(909) 983-2020

Fax

(909) 983-6847

NPI assigned

Apr 9, 2007

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

Other identifiers 1

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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1326161795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 N EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917622762",
            "telephone_number": "909-983-2020",
            "fax_number": "909-983-6847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 N EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917622762",
            "telephone_number": "909-983-2020",
            "fax_number": "909-983-6847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "JED",
        "middle_name": "E.",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS9580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "951946482",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kori Sethman
• Stephanie Severance
• Olivia Sevilla, MSW
• Sadat Leila Azadeh Seyedi-Rezvani
• Fatima Shaalan
• Brian Shaghafi, PA
• Devangi Shah, PHARM.D., BCPS
• Jatin Prabhudas Shah, DDS
• Jay N. Shah, MD
• Ali Shahzad Ghajar, DDS

• Clinical Social Worker in Ontario, CA
• Providers in Ontario, 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 Oct 18, 2012; 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.