Individual provider Active NPI

Jeanne Patricia Newcomer, LCSW

  • Clinical Social Worker
  • Victorville, CA
National Provider Identifier
1629090592
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS6200 Issued in CA
Practice address
15447 Anacapa Rd
Suite 200
Victorville, CA 92392-2481
Phone
(760) 245-9446
Fax
(760) 951-8986
NPI assigned
Jul 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 LCS6200 CA Primary

Addresses

Primary practice location

15447 Anacapa Rd
Suite 200
Victorville, CA 92392-2481

Mailing address

8180 SVL Box
Victorville, CA 92395-5122
Phone (760) 953-0429

Other identifiers 1

IdentifierTypeStateIssuer
6681536MedicaidCA

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS6200CAMDClinical Social Worker
6200CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1629090592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8180 SVL BOX",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955122",
            "telephone_number": "760-953-0429",
            "fax_number": "760-951-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15447 ANACAPA RD",
            "address_2": "SUITE 200",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922481",
            "telephone_number": "760-245-9446",
            "fax_number": "760-951-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWCOMER",
        "first_name": "JEANNE",
        "middle_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS6200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6681536",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.