Individual provider Active NPI

Jassel Vargas

  • Social Worker
  • Riverside, CA
National Provider Identifier
1710502711
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
112283 Issued in CA
Practice address
4590 Allstate Dr
Riverside, CA 92501-1702
Phone
(909) 599-1227
NPI assigned
Jun 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 112283 CA Primary

Addresses

Primary practice location

4590 Allstate Dr
Riverside, CA 92501-1702

Mailing address

4590 Allstate Dr
Riverside, CA 92501-1702

Other practice location 1

3075 Myers St
Riverside, CA 92503-5525
Phone (951) 358-4625

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
112283CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
McKinley Children'S Center, Inc. CurrentSince Jun 18, 2023 Accepting new patients
McKinley Children'S Center CurrentSince Jul 31, 2022 Accepting new patients

Locations

4590 Allstate Dr
Riverside, CA 92501
Phone (909) 449-2731

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": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1710502711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4590 ALLSTATE DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925011702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4590 ALLSTATE DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925011702",
            "telephone_number": "909-599-1227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3075 Myers St",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925035525",
            "country_code": "US",
            "telephone_number": "951-358-4625",
            "fax_number": "951-358-4901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "JASSEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "112283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.