Individual provider Active NPI

Jamie Lynne Humphrey, LCSW

  • Clinical Social Worker
  • Los Gatos, CA
National Provider Identifier
1588068183
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
80189 Issued in CA
Practice address
220 Oak Meadow Dr Ste a
Los Gatos, CA 95032-4407
Phone
(858) 609-9354
NPI assigned
Oct 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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 80189 CA Primary

Addresses

Primary practice location

220 Oak Meadow Dr Ste a
Los Gatos, CA 95032-4407

Mailing address

220 Oak Meadow Dr Ste a
Los Gatos, CA 95032-4407
Phone (858) 609-9354

Other names 1

  • Jamie Lynne St. John Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 8, 2025 through Oct 8, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
80189CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1588068183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 OAK MEADOW DR STE A",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950324407",
            "telephone_number": "858-609-9354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 OAK MEADOW DR STE A",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950324407",
            "telephone_number": "858-609-9354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "JAMIE",
        "middle_name": "LYNNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "80189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "ST. JOHN",
            "middle_name": "LYNNE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.