Carson Sean Jaffrey, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

93897 Issued in CA

Practice address

11838 Bernardo Plaza CT Ste 250
San Diego, CA 92128-2434

Phone

(858) 776-8804

NPI assigned

Apr 6, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 12, 2023 through Dec 12, 2027

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Family Connections Therapy, Inc.

  • Marriage & Family Therapist
  • San Diego, CA
  • NPI 1427340439
  NPD

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1770112286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4231 BALBOA AVE # 1218",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175504",
            "telephone_number": "858-752-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11838 BERNARDO PLAZA CT STE 250",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282434",
            "telephone_number": "858-776-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFFREY",
        "first_name": "CARSON",
        "middle_name": "SEAN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "93897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "93897",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lawrence Jay Jaffe, M.D.
• Lindsey Michelle Jaffe, LCSW
• Shelly Jaffe, LCSW
• Julie Ann Jaffray, M.D.
• Paul Michael Jaffray, M.D.
• Rachna A. Jafri, M.D.
• Priya Jagasia, M.D.
• Amy Elizabeth Jagger, DDS
• April Jeannette Jaggi, NNP-BC
• Elizabeth Jaggie

• 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 Apr 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.