Individual provider Active NPI

Jaleen Tomy, LCSW

  • Clinical Social Worker
  • Vacaville, CA
National Provider Identifier
1457622177
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
27138 Issued in CA
Practice address
400 Boyd St
Vacaville, CA 95688-4522
Phone
(707) 408-2517
NPI assigned
Jan 26, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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 27138 CA Primary

Addresses

Primary practice location

400 Boyd St
Vacaville, CA 95688-4522

Mailing address

200 Prairie CT Unit 2426
Vacaville, CA 95696-3276
Phone (707) 408-2517

Other names 1

  • Jaleen Tomy-Yurong Former name

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
I20181203002646 CA Practitioner - Clinical Social Worker 8022352079 Practice locations: Carlsbad, CA; Oceanside, CA; Fairfield, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

329 Cole Way
Oceanside, CA 92054-5671
Phone (707) 408-2517

490 Chadbourne Rd
FL 2
Fairfield, CA 94534-9613
Phone (707) 408-2517

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27138CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Darrell Broaddus Psychological Services PC Past Accepting new patients

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": "1327536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1457622177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PRAIRIE CT UNIT 2426",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956963276",
            "telephone_number": "707-408-2517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BOYD ST",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956884522",
            "telephone_number": "707-408-2517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMY",
        "first_name": "JALEEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-26",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "27138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JALEEN",
            "last_name": "TOMY-YURONG",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vacaville, CA

Sources for this page

Verify at the official NPI Registry.