Individual provider Active NPI

Jan Feingold Simon, LCSW

  • Clinical Social Worker
  • Rancho Palos Verdes, CA
National Provider Identifier
1770810475
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3656 Issued in CA
Practice address
4272 Stalwart Dr
Rancho Palos Verdes, CA 90275-6025
Phone
(310) 972-0502
Fax
(310) 375-7952
NPI assigned
Nov 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3656 CA Primary

Addresses

Primary practice location

4272 Stalwart Dr
Rancho Palos Verdes, CA 90275-6025

Mailing address

4272 Stalwart Dr
Rancho Palos Verdes, CA 90275-6025
Phone (310) 972-0502

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

Practice roles

OrganizationSpecialtyStatusNew patients
Simon Therapy California a Licesnsed Clinical Social Worker Professional Corporation Clinical CurrentSince Feb 1, 2025 Accepting new patients
Jerald I Simon, M.D., Inc PastSince Feb 1, 2025 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1770810475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4272 STALWART DR",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902756025",
            "telephone_number": "310-972-0502",
            "fax_number": "310-375-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4272 STALWART DR",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902756025",
            "telephone_number": "310-972-0502",
            "fax_number": "310-375-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "JAN",
        "middle_name": "FEINGOLD",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-17",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "3656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Palos Verdes, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.