Individual provider Active NPI

Jessica Sanchez, MSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1609419316
Registry record updated Jun 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
112113 Issued in CA
Practice address
1721 Griffin Ave
Los Angeles, CA 90031-3312
Phone
(323) 221-4134
NPI assigned
Oct 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 112113 CA
Peer Specialist 175T00000X
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 112113 CA Primary

Addresses

Primary practice location

1721 Griffin Ave
Los Angeles, CA 90031-3312

Mailing address

5716 Michigan Ave Ste 4100
Detroit, MI 48210-3039
Phone (313) 963-2266

Other practice location 1

5716 Michigan Ave Ste 4100
Detroit, MI 48210-3039
Phone (313) 963-2266

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

LicenseStateTypeSpecialty
112113CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Counseling Solutions PastSince Oct 1, 2019 Accepting new patients

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": "1571961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686960000000",
    "number": "1609419316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5716 MICHIGAN AVE STE 4100",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482103039",
            "telephone_number": "313-963-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 GRIFFIN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900313312",
            "telephone_number": "323-221-4134"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5716 Michigan Ave Ste 4100",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482103039",
            "country_code": "US",
            "telephone_number": "313-963-2266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "JESSICA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-25",
        "last_updated": "2023-06-17",
        "certification_date": "2023-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "112113",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "112113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.