Jessica Story Anderson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW61295 Issued in CA

Practice address

964 5TH Ave
San Diego, CA 92101-6102

Phone

(858) 255-1658

Fax

(833) 536-2427

NPI assigned

Jan 20, 2022

Last updated

Jan 20, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

New York University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Soul Tide Psychotherapy PCGroup PAC ID 5890286975, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Soul Tide Psychotherapy PC

  • Clinical Psychologist
  • Carlsbad, CA
  • NPI 1528856531
  Medicare reassignment Care Compare group NPD
• Practice of Being Human Psychology PC

  dba Learning to be Human

  • Psychologist
  • San Diego, CA
  • NPI 1982254397
  Medicare reassignment NPD
• Learning to Be Human

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
  • NPI 1386159374
  NPD (past)

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1710639869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "964 5TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921016102",
            "telephone_number": "858-255-1658",
            "fax_number": "833-536-2427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "964 5TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921016102",
            "telephone_number": "858-255-1658",
            "fax_number": "833-536-2427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JESSICA",
        "middle_name": "STORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW61295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Edward Anderson, PT
• Jana C. Anderson, BT
• Jeffrey Anderson, D.C.
• Jenell Anderson
• Jensen Anderson
• Jill Emma Anderson, CRNA
• Joan Marie Anderson, CTRS, RTC, ACC
• Joseph Arthur Anderson, PHARMD
• Julianna Anderson
• Justin Michael Anderson, PA-C

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.