Individual provider Active NPI

Jennifer Ann Zimmerman, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1811449077
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28729 Issued in CA
Practice address
12625 High Bluff Dr Ste 107
San Diego, CA 92130-2053
Phone
(858) 208-3452
NPI assigned
Nov 3, 2016
Last updated
Aug 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 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 28729 CA Primary

Addresses

Primary practice location

12625 High Bluff Dr Ste 107
San Diego, CA 92130-2053

Mailing address

12625 High Bluff Dr Ste 107
San Diego, CA 92130-2053
Phone (858) 208-3452

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
I20170522001352 CA Practitioner - Clinical Social Worker 2365719408 Reassigns benefits to 1 organization
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28729CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Jan 24, 2019 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Jan 24, 2019 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
San Diego Family Care Past Accepting new patients
San Diego Family Care Past Accepting new patients
San Diego Family Care Past Accepting new patients
San Diego Family Care Past Accepting new patients

Locations

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1811449077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12625 HIGH BLUFF DR STE 107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302053",
            "telephone_number": "858-208-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12625 HIGH BLUFF DR STE 107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302053",
            "telephone_number": "858-208-3452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-03",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "28729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.