Individual provider Active NPI

Jessica Faye Taylor

  • Clinical Social Worker
  • Santa Fe Springs, CA
National Provider Identifier
1902258403
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
103947 Issued in CA
Practice address
11721 Telegraph Rd
Building G
Santa Fe Springs, CA 90670-3674
Phone
(562) 949-8455
NPI assigned
Jul 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW78274 CA
Rehabilitation Practitioner 225400000X CA
Clinical Social Worker 1041C0700X 103947 CA Primary

Addresses

Primary practice location

11721 Telegraph Rd
Building G
Santa Fe Springs, CA 90670-3674

Mailing address

11721 Telegraph Rd
Building G
Santa Fe Springs, CA 90670-3674
Phone (562) 949-8455

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
ASW78274CAMDMental Health Counselor
103947CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1902258403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11721 TELEGRAPH RD",
            "address_2": "BUILDING G",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703674",
            "telephone_number": "562-949-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11721 TELEGRAPH RD",
            "address_2": "BUILDING G",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703674",
            "telephone_number": "562-949-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JESSICA",
        "middle_name": "FAYE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-07",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW78274",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "103947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.