Individual provider Active NPI

Jenna Cooper

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1851970479
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
109521 Issued in CA
Practice address
7986 Dagget St
San Diego, CA 92111-2321
Phone
(858) 300-0460
NPI assigned
Apr 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 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 109521 CA Primary

Addresses

Primary practice location

7986 Dagget St
San Diego, CA 92111-2321

Mailing address

8765 Aero Dr Ste 310a
San Diego, CA 92123-1750
Phone (619) 207-0396

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
109521CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Community Services LLC PastSince Feb 23, 2025 Accepting new patients
Pathways Community Services LLC PastSince Feb 23, 2025 Accepting new patients
New Alternatives, Incorporated PastSince Apr 1, 2021 Accepting new patients

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": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1851970479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8765 AERO DR STE 310A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231750",
            "telephone_number": "619-207-0396",
            "fax_number": "858-496-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7986 DAGGET ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921112321",
            "telephone_number": "858-300-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "109521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.