Individual provider Active NPI

Jersson Nieto

  • Social Worker
  • Orange, CA
National Provider Identifier
1396520110
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
131869 Issued in CA
Practice address
4000 W Metropolitan Dr Ste 404
Orange, CA 92868-3504
Phone
(714) 645-8045
NPI assigned
Aug 29, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 131869 CA Primary

Addresses

Primary practice location

4000 W Metropolitan Dr Ste 404
Orange, CA 92868-3504

Mailing address

4000 W Metropolitan Dr Ste 404
Orange, CA 92868-3504
Phone (714) 645-8045

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Orange CurrentSince Nov 7, 2025 Accepting new patients

Locations

4000 W Metropolitan Dr
Ste 404
Orange, CA 92868
Phone (714) 480-5160

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1396520110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 W METROPOLITAN DR STE 404",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683504",
            "telephone_number": "714-645-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 W METROPOLITAN DR STE 404",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683504",
            "telephone_number": "714-645-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIETO",
        "first_name": "JERSSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-29",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "131869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.