Jennifer Renee Ade, LCSW

Individual provider Active NPI Clinical Social Worker · San Pedro, CA

NPI 1992348098 · NPPES record last updated Oct 21, 2019

Key facts

NPI
1992348098
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
19881 (CA)
Practice address
146 N Santa Cruz PL
San Pedro, CA 90732-2922
Phone
(310) 344-9200
Fax
(310) 514-4313
NPI assigned
Oct 21, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
19881CAMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 19881 CA Yes

Addresses

Primary practice location

146 N Santa Cruz PL
San Pedro, CA 90732-2922

Mailing address

146 N Santa Cruz PL
San Pedro, CA 90732-2922
Phone (310) 344-9200

Other providers in San Pedro, CA

All providers in San Pedro, CA · Clinical Social Worker in California

Sources for this page

Verify at the official NPI Registry.