Individual provider Active NPI

Jessica Lisseth Garcia

  • Clinical Social Worker
  • Duarte, CA
National Provider Identifier
1659720308
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
97226 Issued in CA
Practice address
2502 E. Huntington Dr.
Duarte, CA 91010-2221
Phone
(626) 263-9133
NPI assigned
Jun 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 97226 CA
Clinical Social Worker 1041C0700X 97226 CA Primary

Addresses

Primary practice location

2502 E. Huntington Dr.
Duarte, CA 91010-2221

Mailing address

2502 E. Huntington Dr.
Duarte, CA 91010-2221
Phone (626) 263-9133

Other practice location 1

205 Pasadena Ave
South Pasadena, CA 91030-2919
Phone (323) 344-5536

Other practice location 2

4716 E Cesar E Chavez Ave
Los Angeles, CA 90022-1210
Phone (626) 327-7097

Other identifiers 4

IdentifierTypeStateIssuer
7667OtherCAMEDICAL
7368OtherCAMEDICAL
7184OtherCAMEDICAL
7708OtherCAMEDICAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for the Redesign of Learning Mental Health PastSince Nov 1, 2020 Accepting new patients
Institute for the Redesign of Learning Mental Health Past Accepting new patients

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": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1659720308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 E. HUNTINGTON DR.",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910102221",
            "telephone_number": "626-263-9133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 E. HUNTINGTON DR.",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910102221",
            "telephone_number": "626-263-9133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Pasadena Ave",
            "address_purpose": "LOCATION",
            "city": "South Pasadena",
            "state": "CA",
            "postal_code": "910302919",
            "country_code": "US",
            "telephone_number": "323-344-5536",
            "fax_number": "323-344-5550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4716 E Cesar E Chavez Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900221210",
            "country_code": "US",
            "telephone_number": "626-327-7097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "JESSICA",
        "middle_name": "LISSETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-03",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "97226",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "97226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "7667",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "7368",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "7184",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "7708",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duarte, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.