Individual provider Active NPI

Jacque Michael Negrete, L.C.S.W.

  • Clinical Social Worker
  • La Mesa, CA
National Provider Identifier
1699085407
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW82346 Issued in CA
Practice address
8881 Fletcher Pkwy Ste 350-360
La Mesa, CA 91942-3134
Phone
(858) 279-1223
NPI assigned
Oct 14, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2632-C NV
Clinical Social Worker 1041C0700X LCSW82346 CA Primary

Addresses

Primary practice location

8881 Fletcher Pkwy Ste 350-360
La Mesa, CA 91942-3134

Mailing address

PO Box 1259
Selma, CA 93662-1259
Phone (775) 450-1596

Other practice location 1

111 Gallatin St
Shelby, MT 59474-1676
Phone (406) 424-8079

Other practice location 2

9492 Double R Boulevard
Suite B
Reno, NV 89403
Phone (775) 450-1596

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW82346CAMDClinical Social Worker
2632-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Point Counsleing Services Clinical PastSince Jun 23, 2017 Accepting new patients
Connections Behavioral Health Center Clinical PastSince Dec 9, 2017 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": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1699085407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1259",
            "city": "SELMA",
            "state": "CA",
            "postal_code": "936621259",
            "telephone_number": "775-450-1596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8881 FLETCHER PKWY STE 350-360",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423134",
            "telephone_number": "858-279-1223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Gallatin St",
            "address_purpose": "LOCATION",
            "city": "Shelby",
            "state": "MT",
            "postal_code": "594741676",
            "country_code": "US",
            "telephone_number": "406-424-8079",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9492 Double R Boulevard",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "89403",
            "country_code": "US",
            "telephone_number": "775-450-1596",
            "fax_number": "775-246-5034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEGRETE",
        "first_name": "JACQUE",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-14",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "2632-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW82346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; 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.