Andrew Jen, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY19185 Issued in CA

Practice address

11925 Wilshire Blvd
3Rd Floor
Los Angeles, CA 90025-6618

Phone

(310) 453-2772

Fax

(310) 453-3833

NPI assigned

Jul 13, 2007

Last updated

Jul 13, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1073712584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11925 WILSHIRE BLVD",
            "address_2": "3RD FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256618",
            "telephone_number": "310-453-2772",
            "fax_number": "310-453-3833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11925 WILSHIRE BLVD",
            "address_2": "3RD FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256618",
            "telephone_number": "310-453-2772",
            "fax_number": "310-453-3833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEN",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY19185",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY19185",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY19185",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jem Dynamics Inc
• Abera Jembere
• Aster T Jemere, MSW
• Sherrie Elaine Jemison
• Jen Lescher Licensed Clinical Social Worker Inc
• Howard C. Jen, M.D.
• Joanna Chieh Jen, MD
• Sabrina Ping-Hui Jen
• Jeffrey Jeng, M.D.
• Karen Jeng, PHARM.D.

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.