NPIMap

Individual provider Active NPI

Jeannette Yvonne Cruz

  • Clinical Social Worker
  • Bakersfield, CA
National Provider Identifier
1801292859
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
90271 Issued in CA
Practice address
3105 Wilson Rd Ste 100
Bakersfield, CA 93304-5319
Phone
(661) 397-8775
Fax
(661) 397-8286
NPI assigned
Nov 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X 90271 CA Primary

Addresses

Primary practice location

3105 Wilson Rd Ste 100
Bakersfield, CA 93304-5319

Mailing address

3105 Wilson Rd Ste 100
Bakersfield, CA 93304-5319
Phone (661) 397-8775

Other names 1

  • Jeannette Yvonne Salazar Former name

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

LicenseStateTypeSpecialty
90271CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1801292859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 WILSON RD STE 100",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933045319",
            "telephone_number": "661-397-8775",
            "fax_number": "661-397-8286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 WILSON RD STE 100",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933045319",
            "telephone_number": "661-397-8775",
            "fax_number": "661-397-8286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "JEANNETTE",
        "middle_name": "YVONNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-18",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "90271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNETTE",
            "last_name": "SALAZAR",
            "middle_name": "YVONNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.