MEDICARE: JENNIFER DINICOLA LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCS 21520	CA

General Provider Information

NPI Number	:	1861455107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER DINICOLA LCSW

Provider Business Mailing Address
First Line	:	405 W 5TH ST STE 601
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92701-4566
Country	:	US
Telephone Number	:	714-834-8348
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 CITY PKWY W STE 400
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92868-2941
Country	:	US
Telephone Number	:	714-834-8348
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2006
Last Update Date	:	03/19/2026

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