Active NPI
Jill Barbara Wiener, PSYD, LCSW
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1972633329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS5278
- Practice address
- 601 Wilshire Blvd Ste 309
Los Angeles, CA 90017-3207 - Phone
- (310) 741-1127
- NPI assigned
- Mar 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS5278 | CA | Primary |
Addresses
Primary practice location
601 Wilshire Blvd Ste 309
Los Angeles, CA 90017-3207
Mailing address
940 Avenue 64
Pasadena, CA 91105-2711
Phone (323) 254-2274
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140922000382 | CA | Practitioner - Clinical Social Worker | 7315166501 | Practice locations: Los Angeles, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1973
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
13915 Califa St
Van Nuys, CA 91401-4320
611 Wilshire Blvd
Suite 309
Los Angeles, CA 90017-2908
Phone (310) 741-1127
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS5278 | CA | MD | Clinical Social Worker |
| 5278 | CA | MD | Obstetrics & Gynecology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566345600000",
"number": "1972633329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "940 AVENUE 64",
"city": "PASADENA",
"state": "CA",
"postal_code": "911052711",
"telephone_number": "323-254-2274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 WILSHIRE BLVD STE 309",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900173207",
"telephone_number": "310-741-1127"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIENER",
"first_name": "JILL",
"middle_name": "BARBARA",
"credential": "PSYD, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-06",
"last_updated": "2019-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS5278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.