Active NPI
Jessica Perez
- Clinical Social Worker
- Carson, CA
National Provider Identifier
1679930127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 83060
- Practice address
- 1 Civic Plaza Dr FL 3
Carson, CA 90745-2243 - Phone
- (310) 233-1623
- NPI assigned
- Jan 27, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LCSW83060 | CA | |
| Clinical Social Worker | 1041C0700X | 83060 | CA | Primary |
Addresses
Primary practice location
1 Civic Plaza Dr FL 3
Carson, CA 90745-2243
Mailing address
1 Civic Plaza Dr FL 3
Carson, CA 90745-2243
Phone (310) 233-1623
Other practice location 1
921 E Compton Blvd
1st Floor
Compton, CA 90221
Phone (310) 668-6936
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW83060 | CA | MD | Social Worker |
| 83060 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649721600000",
"number": "1679930127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CIVIC PLAZA DR FL 3",
"city": "CARSON",
"state": "CA",
"postal_code": "907452243",
"telephone_number": "310-233-1623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CIVIC PLAZA DR FL 3",
"city": "CARSON",
"state": "CA",
"postal_code": "907452243",
"telephone_number": "310-233-1623"
}
],
"practiceLocations": [
{
"address_1": "921 E Compton Blvd",
"address_2": "1st Floor",
"address_purpose": "LOCATION",
"city": "Compton",
"state": "CA",
"postal_code": "90221",
"country_code": "US",
"telephone_number": "310-668-6936",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEREZ",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-27",
"last_updated": "2022-04-12",
"certification_date": "2022-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "LCSW83060",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "83060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.