Active NPI
Jacqueline Licea
- Clinical Social Worker
- Bellflower, CA
National Provider Identifier
1891972717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW80488
- Practice address
- 9400 Rosecrans Ave
Bellflower, CA 90706-2246 - Phone
- (562) 461-6525
- NPI assigned
- Jan 22, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | ASW 15742 | CA | |
| Clinical Social Worker | 1041C0700X | LCSW80488 | CA | Primary |
Addresses
Primary practice location
9400 Rosecrans Ave
Bellflower, CA 90706-2246
Mailing address
9400 Rosecrans Ave
Bellflower, CA 90706-2246
Phone (562) 461-6525
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 |
|---|---|---|---|
| ASW 15742 | CA | MD | Social Worker |
| LCSW80488 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732233600000",
"number": "1891972717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9400 ROSECRANS AVE",
"city": "BELLFLOWER",
"state": "CA",
"postal_code": "907062246",
"telephone_number": "562-461-6525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9400 ROSECRANS AVE",
"city": "BELLFLOWER",
"state": "CA",
"postal_code": "907062246",
"telephone_number": "562-461-6525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LICEA",
"first_name": "JACQUELINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-22",
"last_updated": "2024-11-22",
"certification_date": "2024-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "ASW 15742",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW80488",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellflower, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.