Individual provider Active NPI

Jackie Garner, ASW

  • Social Worker
  • Laguna Hills, CA
National Provider Identifier
1639442320
Registry record updated Feb 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
ASW27353 Issued in CA
Practice address
23201 Mill Creek Dr Ste 220
Laguna Hills, CA 92653-7906
Phone
(949) 463-5323
Fax
(949) 460-5322
NPI assigned
Feb 11, 2012
Last updated
Feb 11, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X ASW27353 CA Primary

Addresses

Primary practice location

23201 Mill Creek Dr Ste 220
Laguna Hills, CA 92653-7906

Mailing address

23201 Mill Creek Dr Ste 220
Laguna Hills, CA 92653-7906
Phone (949) 463-5323

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190212000733 CA Practitioner - Clinical Social Worker 7416295787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for New Directions IncGroup PAC ID 9335475870, 32 clinicians

Practice addresses (Care Compare)

23201 Mill Creek Dr
Suite 220
Laguna Hills, CA 92653-7906
Phone (888) 795-4337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW27353CAMDSocial Worker
64024CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for New Directions, Inc. CurrentSince Oct 19, 2019 Accepting new patients

Locations

23201 Mill Creek Dr
Ste 220
Laguna Hills, CA 92653
Phone (949) 460-5320

1100 Melody Ln
Ste 108
Roseville, CA 95678

232 W Main St
Ste 101
Tustin, CA 92780
Phone (714) 657-6769

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1328918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328918400000",
    "number": "1639442320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23201 MILL CREEK DR STE 220",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926537906",
            "telephone_number": "949-463-5323",
            "fax_number": "949-460-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23201 MILL CREEK DR STE 220",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926537906",
            "telephone_number": "949-463-5323",
            "fax_number": "949-460-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARNER",
        "first_name": "JACKIE",
        "credential": "ASW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-11",
        "last_updated": "2012-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW27353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

Verify at the official NPI Registry.