Individual provider Active NPI

Jane Edith Wilson

  • Social Worker
  • North Hollywood, CA
National Provider Identifier
1689063646
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
ASW119362 Issued in CA
Practice address
8330 Lankershim Blvd
North Hollywood, CA 91605-1615
Phone
(818) 994-7454
NPI assigned
Jan 14, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Social Worker 104100000X ASW119362 CA Primary

Addresses

Primary practice location

8330 Lankershim Blvd
North Hollywood, CA 91605-1615

Mailing address

17412 Ventura Blvd
#820
Encino, CA 91316-3827
Phone (818) 267-4058

Other practice location 1

11027 Bubank Blvd
North Hollywood, CA 91601
Phone (818) 985-8323 ext. 122

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
ASW119362CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
I-Adarp, Inc. Addiction (Substance Use Disorder) PastSince Sep 5, 2021 Accepting new patients
Cri-Help, Inc. PastSince Sep 5, 2021 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": "1421193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1689063646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17412 VENTURA BLVD",
            "address_2": "#820",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163827",
            "telephone_number": "818-267-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8330 LANKERSHIM BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916051615",
            "telephone_number": "818-994-7454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11027 Bubank Blvd",
            "address_purpose": "LOCATION",
            "city": "North Hollywood",
            "state": "CA",
            "postal_code": "91601",
            "country_code": "US",
            "telephone_number": "818-985-8323 x122",
            "fax_number": "818-985-4297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JANE",
        "middle_name": "EDITH",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-14",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW119362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.