Kimberly Erin Jackson-Massaro, MSW/LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

3031 Morris Ave
Clovis, CA 93619-6904

Phone

(619) 578-9255

NPI assigned

Aug 28, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Kimberly Erin Jackson Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846
  Medicare reassignment NPD

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671235200000",
    "number": "1699969188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 1ST AVE APT 38",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034033",
            "telephone_number": "619-578-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 MORRIS AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936196904",
            "telephone_number": "619-578-9255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON-MASSARO",
        "first_name": "KIMBERLY",
        "middle_name": "ERIN",
        "name_prefix": "Ms.",
        "credential": "MSW/LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2022-12-17",
        "certification_date": "2022-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kimberly.e.jackson-massaro@kp.org",
            "affiliation": "Y",
            "endpointDescription": "Work email",
            "affiliationName": "Kaiser Foundation Health Plan of the Mid Atlantic States, Inc",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7300 N Fresno St",
            "city": "Fresno",
            "state": "CA",
            "country_code": "US",
            "postal_code": "937202942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "JACKSON",
            "middle_name": "ERIN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cory Ipsen, PA-C
• Erika Lezann Ireland, RDN
• Alan Todd Israel, O.D.
• J. a. Mirelez Jr DDS Inc. (Mirelez Revitalize Dental Implant Center)
• Sara Jamal Jaber
• Danielle Erin Jackson, FNP
• Mark Henry Jackson, LCSW
• Rebecca Jackson
• Wesley Gordon Jackson, M.D.
• Jacob's Place LLC

• Social Worker in Clovis, CA
• Providers in Clovis, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.