Individual provider Active NPI

Jeanette Flores

  • Clinical Social Worker
  • Northridge, CA
National Provider Identifier
1679973309
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW121049 Issued in CA
Practice address
9650 Zelzah Ave
Northridge, CA 91325-2003
Phone
(818) 739-5250
NPI assigned
Aug 29, 2014
Last updated
Feb 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Social Worker 1041C0700X NU
Clinical Social Worker 1041C0700X LCSW121049 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

9650 Zelzah Ave
Northridge, CA 91325-2003

Mailing address

204 Hampton Dr
Venice, CA 90291-2623
Phone (310) 396-6468

Other practice location 1

456 Elm Ave
Long Beach, CA 90802-2426
Phone (562) 437-6717

Other practice location 2

204 Hampton Dr
Venice, CA 90291-2623
Phone (310) 396-6468

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

LicenseStateTypeSpecialty
LCSW121049CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Semillas Y Flores Therapy, Inc. Clinical Current Accepting new patients

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": "1409270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1679973309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 HAMPTON DR",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912623",
            "telephone_number": "310-396-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9650 ZELZAH AVE",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913252003",
            "telephone_number": "818-739-5250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "456 Elm Ave",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908022426",
            "country_code": "US",
            "telephone_number": "562-437-6717",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "204 Hampton Dr",
            "address_purpose": "LOCATION",
            "city": "Venice",
            "state": "CA",
            "postal_code": "902912623",
            "country_code": "US",
            "telephone_number": "310-396-6468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLORES",
        "first_name": "JEANETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-29",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW121049",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.