Individual provider Active NPI

Jasmin Esmeralda Avelar, LCSW

  • Clinical Social Worker
  • Indio, CA
National Provider Identifier
1407642630
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113644 Issued in CA
Practice address
82934 Civic Center Dr
Indio, CA 92201-4308
Phone
(760) 477-0733
NPI assigned
Apr 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 113644 CA Primary

Addresses

Primary practice location

82934 Civic Center Dr
Indio, CA 92201-4308

Mailing address

82410 Gable Dr
Indio, CA 92201-7439

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250514000056 CA Practitioner - Clinical Social Worker 1951829944 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113644CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sac Health System Current Accepting new patients
Sac Health System CurrentSince Apr 26, 2025 Accepting new patients
Sac Health System CurrentSince Apr 26, 2025 Accepting new patients

Locations

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

250 S G St
San Bernardino, CA 92410
Phone (909) 771-2990

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

Organizations & group practices 3

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": "1744675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1407642630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82410 GABLE DR",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922017439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82934 CIVIC CENTER DR",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922014308",
            "telephone_number": "760-477-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVELAR",
        "first_name": "JASMIN",
        "middle_name": "ESMERALDA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-15",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "113644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

Verify at the official NPI Registry.