Active NPI
Jennifer Medina, LCSW
- Clinical Social Worker
- Lynwood, CA
National Provider Identifier
1356685689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 138602
- Practice address
- 3680 E Imperial Hwy Ste 220
Lynwood, CA 90262-2663 - Phone
- (323) 769-7163
- Fax
- (310) 886-5326
- NPI assigned
- Nov 27, 2012
- Last updated
- May 13, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 85616 | CA | |
| Social Worker | 104100000X | 34113 | CA | |
| Social Worker | 104100000X | 85616 | CA | |
| Clinical Social Worker | 1041C0700X | 138602 | CA | Primary |
Addresses
Primary practice location
3680 E Imperial Hwy Ste 220
Lynwood, CA 90262-2663
Mailing address
3680 E Imperial Hwy Ste 220
Lynwood, CA 90262-2663
Phone (323) 769-7163
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85616 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Helpline Youth Coundeling, Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Counselor
- Norwalk, CA
- NPI 1689973323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778630400000",
"number": "1356685689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3680 E IMPERIAL HWY STE 220",
"city": "LYNWOOD",
"state": "CA",
"postal_code": "902622663",
"telephone_number": "323-769-7163",
"fax_number": "323-886-5326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3680 E IMPERIAL HWY STE 220",
"city": "LYNWOOD",
"state": "CA",
"postal_code": "902622663",
"telephone_number": "323-769-7163",
"fax_number": "310-886-5326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "JENNIFER",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-27",
"last_updated": "2026-05-13",
"certification_date": "2026-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "85616",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "34113",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "85616",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "138602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynwood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.