Jessica Lynne Clark, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

29340 Issued in CA

Practice address

9343 Tech Center Dr Ste 110
Sacramento, CA 95826-2592

Phone

(916) 379-5876

NPI assigned

Aug 29, 2008

Last updated

Apr 18, 2023By 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 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cognitive Care Solutions Group Inc

  • Cognitive & Behavioral Psychologist
  • Santa Ana, CA
  • NPI 1548614183
  Medicare reassignment NPD
• County of Butte

  • Adult Mental Health Clinic/Center
  • Chico, CA
  • NPI 1578623583
  Medicare reassignment NPD
• County of San Luis Obispo

  dba Community Mental Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Paso Robles, CA
  • NPI 1134287634
  Medicare reassignment NPD
• County of Tulare

  • Community/Behavioral Health Agency
  • Visalia, CA
  • NPI 1407304678
  Medicare reassignment NPD
• Integrated Pain Management Medical Group, Inc.

  dba Boomerang Healthcare

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Walnut Creek, CA
  • NPI 1922198779
  Medicare reassignment NPD
• Moona Medical Group of California PC

  dba Moona Health

  • Mental Health Counselor
  • San Francisco, CA
  • NPI 1023824836
  Medicare reassignment NPD
• County of Butte

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Paradise, CA
  • NPI 1174161343
  NPD
• County of Butte

  dba Oroville Substance Use Treatment and Recovery Services

  • Community/Behavioral Health Agency
  • Oroville, CA
  • NPI 1740348176
  NPD
• County of San Luis Obispo

  dba San Luis Obispo Psychiatric Health Facility

  • Psychiatric Hospital
  • San Luis Obispo, CA
  • NPI 1861698300
  NPD
• County of San Luis Obispo

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Arroyo Grande, CA
  • NPI 1932563053
  NPD
• County of Tulare

  • Community/Behavioral Health Agency
  • Porterville, CA
  • NPI 1518418581
  NPD
• County of Tulare

  dba Visalia Adult Integrated Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Visalia, CA
  • NPI 1770529752
  NPD

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

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1487802773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18225 HALE AVE",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950373547",
            "telephone_number": "408-465-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9343 TECH CENTER DR STE 110",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958262592",
            "telephone_number": "916-379-5876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5170 GOLDEN FOOTHILL PKWY",
            "address_purpose": "LOCATION",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629608",
            "country_code": "US",
            "telephone_number": "530-461-5353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JESSICA",
        "middle_name": "LYNNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-29",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "29340",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "29340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Derby Clark I
• Faye M Clark, MFT
• Fred Allen Clark, PHD, LMFT
• Isaiah James Clark, MD
• James Russell Clark, CADCA
• Jill Jeffers Clark, MA, PHD
• Joeanna Clark
• Julie Alysia Clark, RADT
• Kacee Lynn Clark
• Kaylyn Clark

• Clinical Social Worker in Sacramento, CA
• Providers in Sacramento, 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 Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.