Amy Elizabeth Jennings, LCSW
Individual provider Active NPI Clinical Social Worker · San Diego, CA
NPI 1609549161 · NPPES record last updated Jul 29, 2021
Key facts
- NPI
- 1609549161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 100075 (CA)
- Practice address
- 9606 Tierra Grande St Ste 201
San Diego, CA 92126-6501 - Phone
- (619) 369-5050
- Fax
- (619) 485-5961
- NPI assigned
- Jul 29, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Centro de Salud de la Comunidad de San Ysidro,Inc.
Practice addresses (Care Compare)
4004 Beyer Blvd
San Ysidro, CA 92173-2007
Phone (619) 428-4463
4050 Beyer Blvd
San Ysidro, CA 92173-2007
Phone (619) 662-4100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220322001069 | CA | Practitioner - Clinical Social Worker | 0446645824 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles (3 of 4)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centro de Salud de la Comunidad de San Ysidro Inc | Current |
Accepting new patients | |
| Centro de Salud de la Comunidad de San Ysidro, Inc. | Current |
Accepting new patients | |
| Centro de Salud de la Comunidad de San Ysidro, Inc. | Current | Accepting new patients |
Locations
1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780
1136 D Ave
National City, CA 91950
Phone (619) 336-2300
1601 Precision Park Ln
San Ysidro, CA 92173
Phone (619) 205-4585
4004 Beyer Blvd
San Ysidro, CA 92173
Phone (619) 428-1330
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 100075 | CA | Yes |
Addresses
Primary practice location
9606 Tierra Grande St Ste 201
San Diego, CA 92126-6501
Mailing address
4547 Utah St Apt 3
San Diego, CA 92116-3140
Phone (662) 822-4937
Other practice location 1
4547 Utah St Apt 3
San Diego, CA 92116-3140
Phone (662) 822-4937
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | amy.jennings@ctlcsd.com | Health Information Exchange (HIE) |
Other providers in San Diego, CA
- Jennifer Reiner, DC Inc
- Jennifer T Caruso DMD Inc.
- Jennifer Trang Xa, D.D.S, Inc.
- Mary Rachel Jennings-Mull
- Alina Jennings
- Beverly Michelle Jennings
- Charles Anthony Jennings
- David Jennings
- Elizabeth Jennings
- Justeen Jennings
All providers in San Diego, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.