Active NPI
Jody Swan
- Social Worker
- McKinleyville, CA
National Provider Identifier
1710593173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 109129
- Practice address
- 1560 Betty CT
McKinleyville, CA 95519-4405 - Phone
- (971) 300-1202
- NPI assigned
- Sep 21, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 109129 | CA | Primary |
Addresses
Primary practice location
1560 Betty CT
McKinleyville, CA 95519-4405
Mailing address
655 F St Ste a
Arcata, CA 95521-6366
Phone (971) 300-1202
Other practice location 1
655 F St Ste A
Arcata, CA 95521-6366
Phone (971) 300-1202
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704326400000",
"number": "1710593173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "655 F ST STE A",
"city": "ARCATA",
"state": "CA",
"postal_code": "955216366",
"telephone_number": "971-300-1202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1560 BETTY CT",
"city": "MCKINLEYVILLE",
"state": "CA",
"postal_code": "955194405",
"telephone_number": "971-300-1202"
}
],
"practiceLocations": [
{
"address_1": "655 F St Ste A",
"address_purpose": "LOCATION",
"city": "Arcata",
"state": "CA",
"postal_code": "955216366",
"country_code": "US",
"telephone_number": "971-300-1202",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SWAN",
"first_name": "JODY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-21",
"last_updated": "2024-01-04",
"certification_date": "2024-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "109129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McKinleyville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.