Jackie Nabil Girgis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

24895 Issued in CA

Practice address

23461 S Pointe Dr Ste 220
Laguna Hills, CA 92653-1523

Phone

(949) 900-5380

Fax

(949) 595-0296

NPI assigned

Dec 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1699831255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23461 S POINTE DR STE 220",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531523",
            "fax_number": "949-951-2871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23461 S POINTE DR STE 220",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531523",
            "telephone_number": "949-900-5380",
            "fax_number": "949-595-0296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "762 Cypress St",
            "address_purpose": "LOCATION",
            "city": "San Dimas",
            "state": "CA",
            "postal_code": "917733505",
            "country_code": "US",
            "telephone_number": "909-599-1227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIRGIS",
        "first_name": "JACKIE",
        "middle_name": "NABIL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2022-07-21",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "24895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Anaheim",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Anaheim",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Anaheim",
            "address_1": "23461 S Pointe Dr Ste 220",
            "city": "Laguna Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926531523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ronald D Gim, M.D.
• Ray H Gin, D.C.
• Nathania Ginanto
• Amy L Ginsburg, CP
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• Meillanny Gladness, PSY.D.
• Roger Gleim, MA
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• Kimberly E. Glossbrenner, LCSW
• Romina Angeli Ramos Go

• All providers in Laguna Hills, CA
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.