Individual provider Active NPI

Jason Nerio

  • Marriage & Family Therapist
  • Santa Clara, CA
National Provider Identifier
1013422732
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
123814 Issued in CA
Practice address
5201 Great America Pkwy Ste 320
Santa Clara, CA 95054-1140
Phone
(323) 205-7088
NPI assigned
Dec 4, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 101524 CA
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X 123814 CA Primary

Addresses

Primary practice location

5201 Great America Pkwy Ste 320
Santa Clara, CA 95054-1140

Mailing address

5201 Great America Pkwy Ste 320
Santa Clara, CA 95054-1140

Other practice location 1

233 Baseline Rd
LA Verne, CA 91750
Phone (909) 833-2986

Other practice location 2

160 E Holt Ave
Pomona, CA 91767-5406
Phone (909) 620-2521

Other practice location 3

233 Baseline Rd
LA Verne, CA 91750-2353
Phone (909) 833-2986

Other practice location 4

233 Baseline Rd
LA Verne, CA 91750-2353
Phone (909) 833-2986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240830003096 CA Practitioner - Marriage and Family Therapist 7315486545 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101524CAMDMarriage & Family Therapist
123814CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jun 24, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 24, 2024 Accepting new patients
Southern California Permanente Medical Group Single Specialty Current Accepting new patients

Locations

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

Organizations & group practices 3

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": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1013422732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 GREAT AMERICA PKWY STE 320",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950541140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 GREAT AMERICA PKWY STE 320",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950541140",
            "telephone_number": "323-205-7088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "233 Baseline Rd",
            "address_purpose": "LOCATION",
            "city": "LA Verne",
            "state": "CA",
            "postal_code": "91750",
            "country_code": "US",
            "telephone_number": "909-833-2986",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 E Holt Ave",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917675406",
            "country_code": "US",
            "telephone_number": "909-620-2521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "233 Baseline Rd",
            "address_purpose": "LOCATION",
            "city": "LA Verne",
            "state": "CA",
            "postal_code": "917502353",
            "country_code": "US",
            "telephone_number": "909-833-2986",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "233 Baseline Rd",
            "address_purpose": "LOCATION",
            "city": "LA Verne",
            "state": "CA",
            "postal_code": "917502353",
            "country_code": "US",
            "telephone_number": "909-833-2986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NERIO",
        "first_name": "JASON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-04",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "101524",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "123814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

Verify at the official NPI Registry.