Individual provider Active NPI

Jessica Preston, LCSW

  • Clinical Social Worker
  • Stockton, CA
National Provider Identifier
1649727066
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
100590 Issued in CA
Practice address
1201 N El Dorado St
Stockton, CA 95202-1306
Phone
(209) 468-3760
NPI assigned
Sep 1, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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 100590 CA Primary

Addresses

Primary practice location

1201 N El Dorado St
Stockton, CA 95202-1306

Mailing address

PO Box 97
Valley Springs, CA 95252-0097

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
I20230911003212 CA Practitioner - Clinical Social Worker 0749644631 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100590CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Heritage Medical Group Inc CurrentSince May 1, 2026 Accepting new patients
Brightside Medical, P.C. Past Accepting new patients

Locations

1805 Medical Center Dr
Sn Bernrdno, CA 92411
Phone (909) 877-6333

3625 E Thousand Oaks Blvd
Ste 232
Westlake Village, CA 91362
Phone (818) 518-9715

Organizations & group practices 2

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": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1649727066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97",
            "city": "VALLEY SPRINGS",
            "state": "CA",
            "postal_code": "952520097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N EL DORADO ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021306",
            "telephone_number": "209-468-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "100590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.