Individual provider Active NPI

Karyn Escotillo Jones

  • Mental Health Counselor
  • Chino Hills, CA
National Provider Identifier
1770917320
Registry record updated Oct 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
ASW62118 Issued in CA
Practice address
1907 Boys Republic Dr
Chino Hills, CA 91709-5447
Phone
(909) 628-1217
Fax
(909) 627-9222
NPI assigned
Aug 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW62118 CA Primary

Addresses

Primary practice location

1907 Boys Republic Dr
Chino Hills, CA 91709-5447

Mailing address

1907 Boys Republic Dr
Chino Hills, CA 91709-5447
Phone (909) 628-1217

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250822002301 CA Practitioner - Clinical Social Worker 8820598972 Practice locations: Chino, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14726 Ramona Ave
Suite W15
Chino, CA 91710-5730
Phone (909) 331-5112

14726 Ramona Ave
Suite W15
Chino, CA 91710-5755

PO Box
Suite 473
Chino Hills, CA 91709

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW62118CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1377734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508371200000",
    "number": "1770917320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 BOYS REPUBLIC DR",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917095447",
            "telephone_number": "909-628-1217",
            "fax_number": "909-627-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 BOYS REPUBLIC DR",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917095447",
            "telephone_number": "909-628-1217",
            "fax_number": "909-627-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "KARYN",
        "middle_name": "ESCOTILLO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-29",
        "last_updated": "2017-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW62118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

Verify at the official NPI Registry.