Individual provider Active NPI

Jessica Valdez Depee, LCSW

  • Clinical Social Worker
  • Vallejo, CA
National Provider Identifier
1881077725
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
88279 Issued in CA
Practice address
508 Alabama St
Vallejo, CA 94590-4446
Phone
(510) 229-9685
Fax
(888) 437-1193
NPI assigned
Jul 8, 2015
Last updated
Jan 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ASW66267 CA
Clinical Social Worker 1041C0700X 88279 CA Primary

Addresses

Primary practice location

508 Alabama St
Vallejo, CA 94590-4446

Mailing address

508 Alabama St
Vallejo, CA 94590-4446
Phone (510) 229-9685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191021002721 CA Practitioner - Clinical Social Worker 7113259334 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
88279CAMDClinical Social Worker
ASW66267CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northbay Healthcare Group CurrentSince Oct 7, 2019 Accepting new patients
Northbay Healthcare Group CurrentSince Oct 7, 2019 Accepting new patients

Locations

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

4500 Business Center Dr
Fairfield, CA 94534
Phone (707) 646-4777

4520 Business Center Dr
Ste 200
Fairfield, CA 94534
Phone (707) 646-3500

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1881077725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 ALABAMA ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945904446",
            "telephone_number": "510-229-9685",
            "fax_number": "888-437-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 ALABAMA ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945904446",
            "telephone_number": "510-229-9685",
            "fax_number": "888-437-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDEZ DEPEE",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-08",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW66267",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "88279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.