Jessica Sue Proffit, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ASW 15575 Issued in CA

Practice address

17350 Mount Herrmann St Ste a
Fountain Valley, CA 92708-4114

Phone

(714) 444-3463

NPI assigned

Mar 17, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• LDS Family Services

  dba LDS Family Services CA Fountain Valley

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fountain Valley, CA
  • NPI 1104906098
  NPD (past)

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

{
    "created_epoch": "1174089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467576371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6851 CITRIADORA CT",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928452910",
            "telephone_number": "714-899-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17350 MOUNT HERRMANN ST STE A",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084114",
            "telephone_number": "714-444-3463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROFFIT",
        "first_name": "JESSICA",
        "middle_name": "SUE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW 15575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prestige Healthcare Services
• Prestige Medical Solutions (Prestige Medical Pharmacy)
• Prevail Medical Equipment, Inc.
• Valerie Grijalva Prichard
• Priority Care Medical Group
• Proforma Solutions Corp
• Prohealth Partners a Medical Group
• Promo Call Diagnostic Inc
• Providence Speech and Hearing Center
• Glenn Provost, M.D.

• Clinical Social Worker in Fountain Valley, CA
• Providers in Fountain Valley, 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 Jul 8, 2007; 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.