Elizabeth Penelope Jacobo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

80614 Issued in CA

Practice address

8530 La Mesa Blvd
Suite 202
La Mesa, CA 91942

Phone

(323) 798-7413

Fax

(833) 419-0181

NPI assigned

Aug 19, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Elizabeth Penelope Garcia Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• 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 and National Provider Directory roles.

• Sud Specialty Group - Ca

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1578843686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 WIND RIVER RD",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920194132",
            "telephone_number": "619-203-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8530 LA MESA BLVD",
            "address_2": "SUITE 202",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91942",
            "telephone_number": "323-798-7413",
            "fax_number": "833-419-0181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBO",
        "first_name": "ELIZABETH",
        "middle_name": "PENELOPE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "80614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "1578843686",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "GARCIA",
            "middle_name": "PENELOPE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• J Nelson Chiropractic Corporation
• J. Michael Vidal, OD Inc
• Desiree Jabin, RRT
• Patricia Lyne Jackson, L.AC.
• Shannon Marie Jackson
• Karl Monte Jacobs, M.D.
• James C Jacobsen, MD
• Beth Jean Jacobson, PT, ATC
• Steven M Jaeger, M.D.
• Emily K Jaen, BSN, FNP-C

• Clinical Social Worker in La Mesa, CA
• Providers in La Mesa, 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 Feb 17, 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.