Individual provider Active NPI

Jessica Edith Perez

  • Clinical Social Worker
  • Lancaster, CA
National Provider Identifier
1962985572
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
85619 Issued in CA
Practice address
45111 Fern Ave
Lancaster, CA 93534-2301
Phone
(661) 949-1206
NPI assigned
Sep 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 85619 CA Primary

Addresses

Primary practice location

45111 Fern Ave
Lancaster, CA 93534-2301

Mailing address

45111 Fern Ave
Lancaster, CA 93534-2301
Phone (661) 949-1206

Other practice location 1

6801 Coldwater Canyon Ave
North Hollywood, CA 91605-5162
Phone (818) 763-7231

Other practice location 2

43520 Division St
Lancaster, CA 93535
Phone (661) 266-1210

Other identifiers 1

IdentifierTypeStateIssuer
85583MedicaidCA

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
I20190109001363 CA Practitioner - Clinical Social Worker 5799021903 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
85619CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
JWCH Institute Inc CurrentSince Oct 17, 2024 Accepting new patients
JWCH Institute, Inc. CurrentSince Oct 17, 2024 Accepting new patients
JWCH Institute Inc Current Accepting new patients

Locations

5650 Jillson St
Commerce, CA 90040
Phone (213) 484-1186

954 N Vermont Ave
Los Angeles, CA 90029
Phone (323) 454-4850

12360 Firestone Blvd
Norwalk, CA 90650
Phone (562) 281-0305

Interoperability endpoints

  • Direct secure messaging: jessica.perezlcsw.p1@direct.jwch.nextgenshare.com

Organizations & group practices 5

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": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1962985572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45111 FERN AVE",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342301",
            "telephone_number": "661-949-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45111 FERN AVE",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342301",
            "telephone_number": "661-949-1206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6801 Coldwater Canyon Ave",
            "address_purpose": "LOCATION",
            "city": "North Hollywood",
            "state": "CA",
            "postal_code": "916055162",
            "country_code": "US",
            "telephone_number": "818-763-7231",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "43520 Division St",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "CA",
            "postal_code": "93535",
            "country_code": "US",
            "telephone_number": "661-266-1210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JESSICA",
        "middle_name": "EDITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-10",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "85619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85583",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.