Jill Georgeann Dorn, LCSW
Individual provider Active NPI Clinical Social Worker · Palos Verdes Estates, CA
NPI 1497927644 · NPPES record last updated Mar 21, 2016
Key facts
- NPI
- 1497927644
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCS 23920 (CA)
- Practice address
- 2705 Palos Verdes Dr N
Palos Verdes Estates, CA 90274-1006 - Phone
- (310) 863-0358
- NPI assigned
- Mar 27, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- New York University School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
24520 Hawthorne Blvd
Suite 220
Torrance, CA 90505-6848
Phone (310) 863-0358
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100305000068 | CA | Practitioner - Clinical Social Worker | 7315082070 | Practice locations: Torrance, CA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS 23920 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jill Dorn | Clinical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS 23920 | CA | Yes |
Addresses
Primary practice location
2705 Palos Verdes Dr N
Palos Verdes Estates, CA 90274-1006
Mailing address
2705 Palos Verdes Dr N
Suite 220
Palos Verdes Estates, CA 90274-1006
Phone (310) 863-0358
Other providers in Palos Verdes Estates, CA
- Joseph Cho
- Christina Weiss, LMFT
- Ryan Conahan
- Michelle Spencer Dahle
- Carly Patricia Diller
- Seema Ramesh Doshi
- Carol T. Edwards
- Kevin M. Ehtessabian
- Ryan Ali Ehtessabian
- Patricia Alice Elder
All providers in Palos Verdes Estates, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.