Individual provider Active NPI

Jessica Chen

  • Clinical Social Worker
  • San Francisco, CA
National Provider Identifier
1780107011
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2574 San Bruno Ave
San Francisco, CA 94134-1505
Phone
(415) 391-9686
NPI assigned
Jul 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

2574 San Bruno Ave
San Francisco, CA 94134-1505

Mailing address

1520 Stockton St
San Francisco, CA 94133-3354
Phone (415) 812-9368

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
I20220601001332 CA Practitioner - Clinical Social Worker 1456739515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North East Medical ServicesGroup PAC ID 4284520529, 143 clinicians

Practice addresses (Care Compare)

3431 Taraval St
San Francisco, CA 94116-2050
Phone (415) 391-9686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North East Medical Services CurrentSince May 1, 2022 Accepting new patients
North East Medical Services Current Accepting new patients
North East Medical Services CurrentSince May 1, 2022 Accepting new patients

Locations

1850 Sullivan Ave
Ste 150
Daly City, CA 94015
Phone (650) 991-5880

211 Eastmoor Ave
Daly City, CA 94015
Phone (650) 550-3923

1520 Stockton St
San Francisco, CA 94133

1450 Noriega St
San Francisco, CA 94122

82 Leland Ave
San Francisco, CA 94134
Phone (415) 391-9688

3431 Taraval St
San Francisco, CA 94116

1400 Noriega St
San Francisco, CA 94122
Phone (415) 352-5093

1033 Clement St
San Francisco, CA 94118
Phone 4153919686 ext. 5572

2574 San Bruno Ave
San Francisco, CA 94134
Phone (415) 352-5090

1870 Lundy Ave
San Jose, CA 95131
Phone (408) 573-9686

Organizations & group practices 3

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": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1780107011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 STOCKTON ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941333354",
            "telephone_number": "415-812-9368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2574 SAN BRUNO AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941341505",
            "telephone_number": "415-391-9686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.