Active NPI
Jacqueline Galvez
- Rehabilitation Practitioner
- Van Nuys, CA
National Provider Identifier
1578871760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 14658 Oxnard St
Van Nuys, CA 91411-3119 - Phone
- (818) 785-0103
- NPI assigned
- Sep 22, 2010
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 72688 | CA | |
| Clinical Social Worker | 1041C0700X | 15672 | FL | |
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
14658 Oxnard St
Van Nuys, CA 91411-3119
Mailing address
15849 Sunburst St
North Hills, CA 91343-3137
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 |
|---|---|---|---|
| 72688 | CA | MD | Clinical Social Worker |
| 15672 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
| San Fernando Valley Community Mental Health Center - FSP | Past | Accepting new patients |
Interoperability endpoints
- jacquelinegalvez@tdh.allscriptsdirect.net
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Van Nuys, CA
- NPI 1780838235
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630454400000",
"number": "1578871760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15849 SUNBURST ST",
"city": "NORTH HILLS",
"state": "CA",
"postal_code": "913433137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14658 OXNARD ST",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914113119",
"telephone_number": "818-785-0103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALVEZ",
"first_name": "JACQUELINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-22",
"last_updated": "2021-09-01",
"certification_date": "2021-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "72688",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "15672",
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.