Active NPI
Jennifer Lynn Hare
- Clinical Social Worker
- Lake Forest, CA
National Provider Identifier
1861846354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 91765
- Practice address
- 22471 Aspan St Ste 103
Lake Forest, CA 92630-1644 - Phone
- (949) 458-2715
- Fax
- (949) 458-3583
- NPI assigned
- Apr 20, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 91765 | CA | Primary |
Addresses
Primary practice location
22471 Aspan St Ste 103
Lake Forest, CA 92630-1644
Mailing address
22471 Aspan Sreet
Suite 103
Lake Forest, CA 92630
Phone (949) 458-2715
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
| License | State | Type | Specialty |
|---|---|---|---|
| 91765 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Youth Services | Past | Accepting new patients | |
| New Alternatives Inc. | Past | 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.
-
- Case Management Agency
- Fountain Valley, CA
- NPI 1174989735
-
- Community/Behavioral Health Agency
- Fountain Valley, CA
- NPI 1215484019
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602115200000",
"number": "1861846354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22471 ASPAN SREET",
"address_2": "SUITE 103",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "92630",
"telephone_number": "949-458-2715",
"fax_number": "949-458-3583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22471 ASPAN ST STE 103",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "926301644",
"telephone_number": "949-458-2715",
"fax_number": "949-458-3583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARE",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-20",
"last_updated": "2020-10-08",
"certification_date": "2020-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "91765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Forest, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.