Active NPI
Jessica Ivener, PSYD, LAADC
- Clinical Psychologist
- Woodland Hills, CA
National Provider Identifier
1063004182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY35232
- Practice address
- 5850 Canoga Ave FL 4
Woodland Hills, CA 91367-6554 - Phone
- (805) 908-1866
- NPI assigned
- Feb 10, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCI11100418 | CA | |
| Clinical Psychologist | 103TC0700X | PSY35232 | CA | Primary |
Addresses
Primary practice location
5850 Canoga Ave FL 4
Woodland Hills, CA 91367-6554
Mailing address
5850 Canoga Ave FL 4
Woodland Hills, CA 91367-6554
Phone (805) 908-1866
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 18, 2025 through Nov 18, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCI11100418 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| PSY35232 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737417600000",
"number": "1063004182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5850 CANOGA AVE FL 4",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913676554",
"telephone_number": "805-908-1866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5850 CANOGA AVE FL 4",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913676554",
"telephone_number": "805-908-1866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVENER",
"first_name": "JESSICA",
"name_prefix": "Dr.",
"credential": "PSYD, LAADC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-10",
"last_updated": "2025-01-21",
"certification_date": "2025-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "LCI11100418",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY35232",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodland Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.