Individual provider Active NPI

Joselynn Poole

  • Clinical Social Worker
  • Anaheim, CA
National Provider Identifier
1740689603
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
94172 Issued in CA
Practice address
108 N Vine St
Anaheim, CA 92805-3302
Phone
(562) 274-8571
NPI assigned
Aug 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 94172 CA Primary

Addresses

Primary practice location

108 N Vine St
Anaheim, CA 92805-3302

Mailing address

108 N Vine St
Anaheim, CA 92805-3302

Other practice location 1

505 N Euclid St
Anaheim, CA 92801-5506
Phone (714) 450-4232

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
94172CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1408233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1740689603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N VINE ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N VINE ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053302",
            "telephone_number": "562-274-8571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 N Euclid St",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928015506",
            "country_code": "US",
            "telephone_number": "714-450-4232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POOLE",
        "first_name": "JOSELYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-17",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "94172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.