Active NPI
Lucille Mills Jacobsen, MSW
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1467757799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 28525
- Practice address
- 155 N Occidental Blvd
Los Angeles, CA 90026-4641 - Phone
- (213) 381-2931
- Fax
- (213) 385-0884
- NPI assigned
- Jan 18, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 28525 | CA | Primary |
Addresses
Primary practice location
155 N Occidental Blvd
Los Angeles, CA 90026-4641
Mailing address
155 N Occidental Blvd
Los Angeles, CA 90026-4641
Phone (213) 381-2931
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 |
|---|---|---|---|
| 28525 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295308800000",
"number": "1467757799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 N OCCIDENTAL BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900264641",
"telephone_number": "213-381-2931",
"fax_number": "213-385-0884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 N OCCIDENTAL BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900264641",
"telephone_number": "213-381-2931",
"fax_number": "213-385-0884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSEN",
"first_name": "LUCILLE",
"middle_name": "MILLS",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-18",
"last_updated": "2011-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "28525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.