Chyanne Destini Jean Jenkins

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ASW124330 Issued in CA

Practice address

118 Belle Mill Rd
Red Bluff, CA 96080-2850

Phone

(530) 840-2000

NPI assigned

May 8, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Victor Community Support Services, Inc.

  • Community/Behavioral Health Agency
  • Red Bluff, CA
  • NPI 1720751837
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1689296071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 BELLE MILL RD",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960802850",
            "telephone_number": "530-712-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 BELLE MILL RD",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960802850",
            "telephone_number": "530-840-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1360 E Lassen Ave",
            "address_purpose": "LOCATION",
            "city": "Chico",
            "state": "CA",
            "postal_code": "959737823",
            "country_code": "US",
            "telephone_number": "530-712-8787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "CHYANNE",
        "middle_name": "DESTINI JEAN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-08",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW124330",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Jackson
• Jeannie Early Jacobs, LCSW
• Morgan Jacobs, ISFC, OQP
• Colleen Carol Jaqua, REGISTERED NURSE
• Jeffrey W Grolig MD Inc
• Elias David Jennings
• Lyndsey J Jerry, LVN
• Jaimal Singh Johal, MD
• John E. Kemp,M.D.,Inc.
• John Thomas, M.D. Inc.

• Clinical Social Worker in Red Bluff, CA
• Providers in Red Bluff, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.