Individual provider Active NPI

Dori Marie Jarrell, LCSW

  • Clinical Social Worker
  • Vacaville, CA
National Provider Identifier
1508643313
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW110573 Issued in CA
Practice address
907 Cedar Brook LN
Vacaville, CA 95687-5261
Phone
(707) 908-3819
NPI assigned
Sep 13, 2023
Last updated
Sep 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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 LCSW110573 CA Primary

Addresses

Primary practice location

907 Cedar Brook LN
Vacaville, CA 95687-5261

Mailing address

907 Cedar Brook LN
Vacaville, CA 95687-5261
Phone (707) 908-3819

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

LicenseStateTypeSpecialty
LCSW110573CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1508643313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 CEDAR BROOK LN",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956875261",
            "telephone_number": "707-908-3819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 CEDAR BROOK LN",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956875261",
            "telephone_number": "707-908-3819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRELL",
        "first_name": "DORI",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW110573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.