Jackelin Chavez Rueda

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1920 Tienda Dr. #101
Lodi, CA 95242

Phone

(209) 647-0398

Fax

(209) 625-0492

NPI assigned

Apr 7, 2014

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Frank Anthony Garcia, LMFT

  • Marriage & Family Therapist
  • Woodbridge, CA
  • NPI 1902741648
  NPD (past)
• Riverside Therapy Group

  • Adolescent and Children Mental Health Clinic/Center
  • Woodbridge, CA
  • NPI 1487131595
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1376962308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 6779",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95206",
            "telephone_number": "209-368-2532",
            "fax_number": "209-625-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 TIENDA DR. #101",
            "city": "LODI",
            "state": "CA",
            "postal_code": "95242",
            "telephone_number": "209-647-0398",
            "fax_number": "209-625-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUEDA",
        "first_name": "JACKELIN",
        "middle_name": "CHAVEZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Rowerdink
• David E Rowley
• Royal Hearts Nursing in-Home Care
• Jonathan M Royce, P.T.
• Vanessa Rubi
• Mary Elizabeth Ruiz, AMFT
• Alecia Nicole Russell, D.O.
• Carrie Dee Rutledge-Spencer, LEP
• Abdollah A. Sabet, MD
• Leslie D Sackschewsky, MD

• Clinical Social Worker in Lodi, CA
• Providers in Lodi, 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 Nov 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.