Individual provider Active NPI

Jennifer Lynn Marsh, LCSW

  • Clinical Social Worker
  • San Ramon, CA
National Provider Identifier
1861627747
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW69608 Issued in CA
Practice address
2603 Camino Ramon
Ste 433
San Ramon, CA 94583-9129
Phone
(925) 444-0821
Fax
(925) 475-8249
NPI assigned
May 21, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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 LCSW69608 CA Primary

Addresses

Primary practice location

2603 Camino Ramon
Ste 433
San Ramon, CA 94583-9129

Mailing address

2748 Corey PL
San Ramon, CA 94583-2407
Phone (408) 901-9116

Other practice location 1

5385 Canyon Crest Dr
San Ramon, CA 94582-4811
Phone (408) 901-9116

Other practice location 2

2821 Crow Canyon Rd Ste 202
San Ramon, CA 94583-1659
Phone (408) 901-9116

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW69608CAMDClinical Social Worker
69608CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Glenn Medical Center, LLC Past Accepting new patients
Mood Clinical, P. C. PastSince Jun 15, 2021 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": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1861627747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2748 COREY PL",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945832407",
            "telephone_number": "408-901-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 CAMINO RAMON",
            "address_2": "STE 433",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945839129",
            "telephone_number": "925-444-0821",
            "fax_number": "925-475-8249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5385 Canyon Crest Dr",
            "address_purpose": "LOCATION",
            "city": "San Ramon",
            "state": "CA",
            "postal_code": "945824811",
            "country_code": "US",
            "telephone_number": "408-901-9116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2821 Crow Canyon Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "San Ramon",
            "state": "CA",
            "postal_code": "945831659",
            "country_code": "US",
            "telephone_number": "408-901-9116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSH",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-21",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW69608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.