Jennifer A Sederholm, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16947 Issued in CA

Practice address

405 Chinn St
Santa Rosa, CA 95404-4309

Phone

(707) 387-0304

NPI assigned

Aug 26, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1396992897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 CHINN ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 CHINN ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044309",
            "telephone_number": "707-387-0304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9445 Farnham St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921231308",
            "country_code": "US",
            "telephone_number": "858-692-7492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEDERHOLM",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-26",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "16947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis Glen Sebera
• William Sechrist, RN
• Cyrus Sedagatnia
• Marisela Sedano, LMFT
• Debra Ann Sedeno
• Lena Miriam Sedlik
• Seek Optimal Health a Professional Corporation
• Chloe Joy Seekins
• Brien A. Seeley, M.D.
• Gabriel A Seely

• Clinical Social Worker in Santa Rosa, CA
• Providers in Santa Rosa, 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 Aug 22, 2022; 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.