Individual provider Active NPI

Jennifer Crystal Sanchez

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1932568896
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW122958 Issued in CA
Practice address
9265 Sky Park CT Ste 100
San Diego, CA 92123-4375
Phone
(844) 737-3638
Fax
(619) 403-9496
NPI assigned
Feb 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X ASW85175 CA
Clinical Social Worker 1041C0700X LCSW122958 CA Primary

Addresses

Primary practice location

9265 Sky Park CT Ste 100
San Diego, CA 92123-4375

Mailing address

200 Pine Ave Ste 400
Long Beach, CA 90802-3039
Phone (714) 904-4097

Other practice location 1

100 W Broadway Ste 5010
Long Beach, CA 90802-9409
Phone (714) 904-4097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4849 Ronson CT
Suite 207
San Diego, CA 92111-1805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW85175CAMDSocial Worker
LCSW122958CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Serene Health Clinical CurrentSince Jun 4, 2024 Accepting new patients
Serene Health Ipa CurrentSince Jun 4, 2024 Accepting new patients

Locations

9265 Sky Park Ct
Ste 100
San Diego, CA 92123
Phone (619) 329-4483

4849 Ronson Ct
Ste 207
San Diego, CA 92111
Phone (619) 329-4483

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": "1455840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1932568896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PINE AVE STE 400",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908023039",
            "telephone_number": "714-904-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9265 SKY PARK CT STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234375",
            "telephone_number": "844-737-3638",
            "fax_number": "619-403-9496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 W Broadway Ste 5010",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908029409",
            "country_code": "US",
            "telephone_number": "714-904-4097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "JENNIFER",
        "middle_name": "CRYSTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-19",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW85175",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW122958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.