Jessica Lynne Rose Kubas, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

80502 Issued in CA

Practice address

103 Providence Mine Rd
Ste 104a
Nevada City, CA 95959-2949

Phone

(530) 402-5613

NPI assigned

Mar 16, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Clinical

  Medicare reassignment NPD
• Sud Specialty Group - Ca

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Clinical

  Medicare reassignment NPD
• Peach Tree Healthcare

  • Federally Qualified Health Center (FQHC)
  • Marysville, CA
  • NPI 1003863622
  Medicare reassignment
• Darrell Broaddus Psychological Services PC

  • Clinical Psychologist
  • Orangevale, CA
  • NPI 1215339650
  NPD (past)

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1629571542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2615",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "95959",
            "telephone_number": "530-402-5613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 PROVIDENCE MINE RD",
            "address_2": "STE 104A",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959592949",
            "telephone_number": "530-402-5613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "206 Prodience Mine Rd",
            "address_2": "Suite 215",
            "address_purpose": "LOCATION",
            "city": "Nevada City",
            "state": "CA",
            "postal_code": "95959",
            "country_code": "US",
            "telephone_number": "530-402-5613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUBAS",
        "first_name": "JESSICA",
        "middle_name": "LYNNE ROSE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-16",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "80502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew William Kneier, PH.D.
• Susan I. Kobrin, MA, MFT
• Michelle Krick, PT
• Garrett Carl Kronland, LMFT
• Sharon Dawn Krusi, LMFT
• Kuhn Medical PC
• Yasemin Kurama
• Hope Louise Kusy
• Tara N Lacount, RADT
• Carey E Laine, PSY.D.

• Clinical Social Worker in Nevada City, CA
• Providers in Nevada City, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.