Active NPI
Evelyn Susan Jacoby-Miller, MSW, LCSW
- Clinical Social Worker
- Long Beach, CA
National Provider Identifier
1487840773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS 5470
- Practice address
- 161 W Victoria St
Long Beach, CA 90805-2175 - Phone
- (310) 603-1030
- NPI assigned
- Sep 20, 2007
- Sex
- Female
- Sole proprietor
- No
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 | LCS 5470 | CA | Primary |
Addresses
Primary practice location
161 W Victoria St
Long Beach, CA 90805-2175
Mailing address
161 W Victoria St
Long Beach, CA 90805-2175
Phone (310) 603-1030
Other names 1
- Ms. Evelyn Susan Jacoby
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 |
|---|---|---|---|
| LCS 5470 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tonya M. Javadi, Inc | Clinical | 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": "1190246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370822400000",
"number": "1487840773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 W VICTORIA ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908052175",
"telephone_number": "310-603-1030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 W VICTORIA ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908052175",
"telephone_number": "310-603-1030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBY-MILLER",
"first_name": "EVELYN",
"middle_name": "SUSAN",
"name_prefix": "Mrs.",
"credential": "MSW, LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-20",
"last_updated": "2013-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS 5470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "EVELYN",
"last_name": "JACOBY",
"middle_name": "SUSAN",
"prefix": "MS.",
"credential": "MSW, LCSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.