Active NPI
Briselda Tejeda
- Clinical Social Worker
- Fullerton, CA
National Provider Identifier
1740718451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 112386
- Practice address
- 801 E Chapman Ave Ste 203
Fullerton, CA 92831-3846 - Phone
- (714) 680-9000
- Fax
- (714) 680-8233
- NPI assigned
- May 24, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 77611 | CA | |
| Clinical Social Worker | 1041C0700X | 112386 | CA | Primary |
Addresses
Primary practice location
801 E Chapman Ave Ste 203
Fullerton, CA 92831-3846
Mailing address
PO Box 919
Fullerton, CA 92836-0919
Phone (714) 680-9000
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
| License | State | Type | Specialty |
|---|---|---|---|
| 112386 | CA | MD | Clinical Social Worker |
| 77611 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crittenton Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Case Management Agency
- Fullerton, CA
- NPI 1699143545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689120000000",
"number": "1740718451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 919",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928360919",
"telephone_number": "714-680-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 E CHAPMAN AVE STE 203",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928313846",
"telephone_number": "714-680-9000",
"fax_number": "714-680-8233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEJEDA",
"first_name": "BRISELDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-24",
"last_updated": "2023-07-12",
"certification_date": "2023-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "77611",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "112386",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.