Individual provider Active NPI

Jeffrey Fluck, LCSW 139421

  • Clinical Social Worker
  • Upland, CA
National Provider Identifier
1851934673
Registry record updated Jun 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW139421 Issued in CA
Practice address
239 W 9TH St
Upland, CA 91786-5979
Phone
(909) 981-6121
NPI assigned
Oct 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2026

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 LCSW139421 CA Primary

Addresses

Primary practice location

239 W 9TH St
Upland, CA 91786-5979

Mailing address

239 W 9TH St
Upland, CA 91786-5979
Phone (909) 981-6121

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
ASW130763CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
His House New Creation Treatment Center CurrentSince Dec 8, 2024 Accepting new patients
G & C Swan Inc CurrentSince Dec 8, 2024 Accepting new patients

Organizations & group practices 2

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": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782518400000",
    "number": "1851934673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 W 9TH ST",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865979",
            "telephone_number": "909-981-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 W 9TH ST",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865979",
            "telephone_number": "909-981-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLUCK",
        "first_name": "JEFFREY",
        "credential": "LCSW 139421",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-24",
        "last_updated": "2026-06-27",
        "certification_date": "2026-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW139421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2026; 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.