Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jessica Story Anderson

Individual provider Clinical Social Worker · NPI 1710639869

Jessica Story Anderson is a Clinical Social Worker in San Diego, California. Graduated from New York University School of Medicine in 2006, 20 years ago. Practices with Soul Tide Psychotherapy PC, a 2-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
20
Trained at
New York University School of Medicine
Licensed in
CA
In the registry since
2022
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Practice location Address checks out

964 5th Ave
San Diego, CA 92101-6102
Phone: (858) 255-1658
Fax: (833) 536-2427
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW61295 (CA)

Record details

NPI number1710639869
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 20, 2022
Last updated in NPPESJanuary 20, 2022
Certification dateJanuary 20, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolNEW YORK UNIVERSITY SCHOOL OF MEDICINE
Graduated 2006 (20 years in practice)
Group practice Soul Tide Psychotherapy Pc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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