Jack Leon Charles Erwin, M.S. PSYCHOLOGY, CLI

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT11707 Issued in CA

Practice address

20688 4TH Street, Suite 8
Saratoga, CA 95070

Phone

(408) 987-9033

NPI assigned

Mar 11, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1073371498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "JACK LEON CHARLES ERWIN",
            "address_2": "20688 4TH STREET, SUITE 8",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "95070",
            "telephone_number": "408-987-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20688 4TH STREET, SUITE 8",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "95070",
            "telephone_number": "408-987-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERWIN",
        "first_name": "JACK",
        "middle_name": "LEON CHARLES",
        "name_prefix": "Mr.",
        "credential": "M.S. PSYCHOLOGY, CLI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT11707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yianni Ellenikiotis, D.M.D
• Mark Derek Emerson, DC
• Michael Emerson
• Daniel E Erdman, MD
• Erik Schraga MD
• Elise Eschen
• Esra S. Yener, DDS, Inc.
• Robert Allen Fischer, MD
• Duane Fong, D.D.S.
• Lesley Marie Fox, D.D.S.

• Marriage & Family Therapist in Saratoga, CA
• Providers in Saratoga, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.