Individual provider Active NPI

Jaqueline Zavala

  • Social Worker
  • Pasadena, CA
National Provider Identifier
1992434468
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
ASW116145 Issued in CA
Practice address
1520 N Raymond Ave # 2-7
Pasadena, CA 91103-1819
Phone
(626) 396-5920
NPI assigned
Jun 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ASW116145 CA
Student in an Organized Health Care Education/Training Program 390200000X
Social Worker 104100000X ASW116145 CA Primary

Addresses

Primary practice location

1520 N Raymond Ave # 2-7
Pasadena, CA 91103-1819

Mailing address

456 E Orange Grove Blvd Unit 302
Pasadena, CA 91104-5237

Other practice location 1

2919 Mission St
San Francisco, CA 94110-3917
Phone (415) 229-0500

Other practice location 2

919 1st St
San Fernando, CA 91340-2957
Phone (818) 256-1124

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
ASW116145CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pasadena Unified School District CurrentSince Sep 8, 2024 Accepting new patients

Locations

1520 N Raymond Ave
#27
Pasadena, CA 91103
Phone (626) 396-5920

Organizations & group practices 1

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": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1992434468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 E ORANGE GROVE BLVD UNIT 302",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911045237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 N RAYMOND AVE # 2-7",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031819",
            "telephone_number": "626-396-5920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2919 Mission St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941103917",
            "country_code": "US",
            "telephone_number": "415-229-0500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "919 1st St",
            "address_purpose": "LOCATION",
            "city": "San Fernando",
            "state": "CA",
            "postal_code": "913402957",
            "country_code": "US",
            "telephone_number": "818-256-1124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAVALA",
        "first_name": "JAQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW116145",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW116145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.