Audrey Sophia Jarahzadeh, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

80391 Issued in CA

Practice address

1901 1St Ave Ste 104
San Diego, CA 92101-0300

Phone

(310) 770-2431

NPI assigned

Jan 28, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Audrey Sophia Jarahzadeh Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Audrey Sophia Jarahzadeh, Licensed Clinical Social Worker, P.C

  • Clinical Social Worker
  • San Diego, CA
  • NPI 1508506072
  NPD Authorized official

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

{
    "created_epoch": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1811640931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9740 CAMPO RD STE 1015",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919771415",
            "telephone_number": "310-770-2431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 1ST AVE STE 104",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921010300",
            "telephone_number": "310-770-2431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARAHZADEH",
        "first_name": "AUDREY",
        "middle_name": "SOPHIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-28",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "80391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDREY",
            "last_name": "JARAHZADEH",
            "middle_name": "SOPHIA",
            "prefix": "MS.",
            "credential": "FABRE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Taylor Brooke Jaquay, CTRS
• Melanie Renee Jaquess, CMT
• Beth Marie Jara, RN
• Denise Antonette Jara, LAC
• Raquel Jara
• Elias Jaraicie, M.D.
• Andrea Jaramillo
• Andres C Jaramillo
• Cecilia Eva Jaramillo
• Elizabeth Comer Jaramillo, AU.D, CNIM

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; 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.