Individual provider Active NPI

Jolene Rae Ford, LCSW

  • Clinical Social Worker
  • West Sacramento, CA
National Provider Identifier
1568796605
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
86984 Issued in CA
Practice address
500 Jefferson Blvd Ste B195
West Sacramento, CA 95605-2350
Phone
(916) 403-2970
NPI assigned
Sep 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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 86984 CA Primary

Addresses

Primary practice location

500 Jefferson Blvd Ste B195
West Sacramento, CA 95605-2350

Mailing address

500 Jefferson Blvd Ste B195
West Sacramento, CA 95605-2350
Phone (916) 403-2970

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200610001119 CA Practitioner - Clinical Social Worker 5890116206 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Clinical CurrentSince Apr 30, 2024 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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": "1253577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1568796605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 JEFFERSON BLVD STE B195",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956052350",
            "telephone_number": "916-403-2970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 JEFFERSON BLVD STE B195",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956052350",
            "telephone_number": "916-403-2970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "JOLENE",
        "middle_name": "RAE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-22",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "86984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Sacramento, CA

Sources for this page

Verify at the official NPI Registry.