Individual provider Active NPI

Jessica Duncan

  • Mental Health Counselor
  • San Jose, CA
National Provider Identifier
1104208453
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1075 E Santa Clara St
San Jose, CA 95116-2244
Phone
(408) 792-3910
NPI assigned
Jun 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1075 E Santa Clara St
San Jose, CA 95116-2244

Mailing address

# 500
Scu - 3045
Santa Clara, CA 95053-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1104208453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "# 500",
            "address_2": "SCU - 3045",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950530001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 E SANTA CLARA ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951162244",
            "telephone_number": "408-792-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; 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.