Individual provider Active NPI

Jon Stovall, MA, MFT

  • Marriage & Family Therapist
  • Lancaster, CA
National Provider Identifier
1053518738
Registry record updated May 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC14975 Issued in CA
Practice address
921 W Avenue J
Suite C
Lancaster, CA 93534-3443
Phone
(661) 949-0131
NPI assigned
Jun 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC14975 CA Primary

Addresses

Primary practice location

921 W Avenue J
Suite C
Lancaster, CA 93534-3443

Mailing address

1529 E Palmdale Blvd
Suite 200
Palmdale, CA 93550-2034
Phone (661) 949-0131

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
I20240425001280 CA Practitioner - Marriage and Family Therapist 5395185284 Reassigns benefits to 1 organization
Practice locations: San Fernando, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC14975CAMDMarriage & Family Therapist
49175CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca Marriage & Family Therapist CurrentSince May 1, 2025 Accepting new patients
All for Kids Organization PastSince Dec 21, 2025 Accepting new patients

Locations

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369872000000",
    "number": "1053518738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 E PALMDALE BLVD",
            "address_2": "SUITE 200",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935502034",
            "telephone_number": "661-949-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 W AVENUE J",
            "address_2": "SUITE C",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935343443",
            "telephone_number": "661-949-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVALL",
        "first_name": "JON",
        "credential": "MA, MFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2013-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC14975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.