Active NPI
Jesse Katherine Vazzano, LICSW, LCSW
- Clinical Social Worker
- Salt Lake City, UT
National Provider Identifier
1417025040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 089.0046104
- Practice address
- VA Salt Lake City Health Care System
500 Foothill Blvd
Salt Lake City, UT 84148 - Phone
- (801) 582-1565
- NPI assigned
- Dec 1, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 089.0046104 | VT | Primary |
| Clinical Social Worker | 1041C0700X | 14228253-3501 | UT |
Addresses
Primary practice location
VA Salt Lake City Health Care System
500 Foothill Blvd
Salt Lake City, UT 84148
Mailing address
VA Salt Lake City Health Care System
500 Foothill Blvd
Salt Lake City, UT 84148
Phone (801) 582-1565
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 |
|---|---|---|---|
| 14228253-3501 | UT | MD | Clinical Social Worker |
| 089.0046104 | VT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764892800000",
"number": "1417025040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "VA SALT LAKE CITY HEALTH CARE SYSTEM",
"address_2": "500 FOOTHILL BLVD",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "84148",
"telephone_number": "801-582-1565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "VA SALT LAKE CITY HEALTH CARE SYSTEM",
"address_2": "500 FOOTHILL BLVD",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "84148",
"telephone_number": "801-582-1565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAZZANO",
"first_name": "JESSE",
"middle_name": "KATHERINE",
"name_prefix": "Ms.",
"credential": "LICSW, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2025-12-05",
"certification_date": "2025-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VT",
"license": "089.0046104",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "14228253-3501",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.