Active NPI
Jeanet Vargas
- Clinical Social Worker
- Long Beach, CA
National Provider Identifier
1609055755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 88806
- Practice address
- 240 E 20TH St
Long Beach, CA 90806-5418 - Phone
- (562) 218-4095
- NPI assigned
- Oct 25, 2007
- 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 | ASW62613 | CA | |
| Case Manager/Care Coordinator | 171M00000X | |||
| Clinical Social Worker | 1041C0700X | 88806 | CA | Primary |
Addresses
Primary practice location
240 E 20TH St
Long Beach, CA 90806-5418
Mailing address
2114 Myrtle Ave
Long Beach, CA 90806-4831
Phone (310) 940-2140
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ASW62613 | Other | CA | ACSW |
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 |
|---|---|---|---|
| ASW62613 | CA | MD | Clinical Social Worker |
| 88806 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609113600000",
"number": "1609055755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2114 MYRTLE AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908064831",
"telephone_number": "310-940-2140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 E 20TH ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908065418",
"telephone_number": "562-218-4095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARGAS",
"first_name": "JEANET",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-25",
"last_updated": "2020-12-28",
"certification_date": "2020-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW62613",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "88806",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACSW",
"identifier": "ASW62613",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.