Individual provider Active NPI

Jessica Yvette Fernandez

  • Clinical Social Worker
  • Alexandria, VA
National Provider Identifier
1992598536
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904018401 Issued in VA
Practice address
4850 Mark Center Dr
Alexandria, VA 22311-1882
Phone
(703) 746-3400
NPI assigned
May 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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 0904018401 VA Primary

Addresses

Primary practice location

4850 Mark Center Dr
Alexandria, VA 22311-1882

Mailing address

4850 Mark Center Dr
Alexandria, VA 22311-1882
Phone (703) 746-3400

Other practice location 1

5417 Backlick Rd
Springfield, VA 22151-3915
Phone (571) 366-0086

Other names 1

  • Jessica Yvette Menjivar Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20250917001442 VA Practitioner - Clinical Social Worker 8729582382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11585 Mohican Rd
Woodbridge, VA 22192-1150

7969 Ashton Ave
Manassas, VA 20109-2885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prince William County Community Services Board CurrentSince Sep 2, 2025 Accepting new patients
Prince William County CurrentSince Sep 2, 2025 Accepting new patients

Locations

7969 Ashton Ave
Manassas, VA 20109
Phone (703) 792-7826

14011 Worth Ave
Ste 110
Woodbridge, VA 22192

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": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1992598536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 MARK CENTER DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111882",
            "telephone_number": "703-746-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 MARK CENTER DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111882",
            "telephone_number": "703-746-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5417 Backlick Rd",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "VA",
            "postal_code": "221513915",
            "country_code": "US",
            "telephone_number": "571-366-0086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "JESSICA",
        "middle_name": "YVETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-27",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904018401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MENJIVAR",
            "middle_name": "YVETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.