Individual provider Active NPI

Jori Leslie, LCSW

  • Clinical Social Worker
  • Capitola, CA
National Provider Identifier
1467670422
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW74847 Issued in CA
Practice address
815 Bay Ave
Capitola, CA 95010-2106
Phone
(831) 460-7385
NPI assigned
Apr 23, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 LCSW74847 CA Primary

Addresses

Primary practice location

815 Bay Ave
Capitola, CA 95010-2106

Mailing address

239 Glenwood Ave
Santa Cruz, CA 95060-2914
Phone (831) 420-7956

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
I20171207000402 CA Practitioner - Clinical Social Worker 7810254497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

815 Bay Ave
Capitola, CA 95010-2106
Phone (831) 423-4111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LCSW74847CAMDClinical Social Worker
74847CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Sep 26, 2017 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Sep 26, 2017 Accepting new patients

Locations

4053 Lone Tree Way
Ste 200
Antioch, CA 94531
Phone (925) 756-3400

4053 Lone Tree Way
Ste 201
Antioch, CA 94531
Phone (925) 756-3400

2500 Milvia St
Berkeley, CA 94704
Phone (510) 204-5514

500 San Pablo Ave
Berkeley, CA 94706
Phone (510) 204-8130

350 John Muir Pkwy
Ste 175
Brentwood, CA 94513
Phone (925) 776-7725

350 John Muir Pkwy
Ste 140
Brentwood, CA 94513
Phone (925) 513-2483

815 Bay Ave
Capitola, CA 95010
Phone (831) 460-7333

160 Green Valley Rd
Freedom, CA 95019
Phone (831) 763-9700

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

5730 Telegraph Ave
Ste 117
Oakland, CA 94609
Phone (510) 204-1507

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

3838 California St
Rm 805
San Francisco, CA 94118
Phone (415) 600-0940

1100 Van Ness Ave
Fl 4
San Francisco, CA 94109
Phone (415) 600-0930

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

2025 Soquel Ave
Santa Cruz, CA 95062
Phone (408) 423-4111

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1467670422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 GLENWOOD AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950602914",
            "telephone_number": "831-420-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 BAY AVE",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102106",
            "telephone_number": "831-460-7385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESLIE",
        "first_name": "JORI",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW74847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Capitola, CA

Sources for this page

Verify at the official NPI Registry.