Individual provider Active NPI

Jayci Grisafe

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1861110272
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22327 Issued in CA
Practice address
438 Camino del Rio S Ste 106
San Diego, CA 92108-3546
Phone
(562) 895-8090
NPI assigned
Aug 22, 2022
Last updated
Aug 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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 22327 CA Primary

Addresses

Primary practice location

438 Camino del Rio S Ste 106
San Diego, CA 92108-3546

Mailing address

2201 E. Willow St. #D - PMB 273
Signal Hill, CA 90755

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
22327CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1861110272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 E. WILLOW ST. #D - PMB 273",
            "city": "SIGNAL HILL",
            "state": "CA",
            "postal_code": "90755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 CAMINO DEL RIO S STE 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083546",
            "telephone_number": "562-895-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISAFE",
        "first_name": "JAYCI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "22327",
            "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 Aug 22, 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.