Individual provider Active NPI

Nicholle Jennings, MSW

  • Clinical Social Worker
  • Bakersfield, CA
National Provider Identifier
1417208133
Registry record updated Apr 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
83421 Issued in CA
Practice address
4900 California Ave Ste. 400B
Bakersfield, CA 93309-7081
Phone
(661) 459-1900
NPI assigned
Sep 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 83421 CA Primary

Addresses

Primary practice location

4900 California Ave Ste. 400B
Bakersfield, CA 93309-7081

Mailing address

4900 California Ave Ste 400B
Bakersfield, CA 93309-7081
Phone (661) 630-7048

Other practice location 1

1400 S Union Ave Ste 100
Bakersfield, CA 93307-4179
Phone (661) 397-8775

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
83421CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1417208133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 CALIFORNIA AVE STE 400B",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933097081",
            "telephone_number": "661-630-7048",
            "fax_number": "661-869-1503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 CALIFORNIA AVE STE. 400B",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933097081",
            "telephone_number": "661-459-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 S Union Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "933074179",
            "country_code": "US",
            "telephone_number": "661-397-8775",
            "fax_number": "661-397-8286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "NICHOLLE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-20",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "83421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; 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.