Individual provider Active NPI

Jessica C Kubota

  • Marriage & Family Therapist
  • Rosemead, CA
National Provider Identifier
1124351390
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
77131 Issued in CA
Practice address
7600 E Graves Ave
Rosemead, CA 91770-3414
Phone
(626) 280-6510
NPI assigned
Sep 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMFT 62970 CA
Marriage & Family Therapist 106H00000X 77131 CA Primary
Rehabilitation Practitioner 225400000X

Addresses

Primary practice location

7600 E Graves Ave
Rosemead, CA 91770-3414

Mailing address

7600 E Graves Ave
Rosemead, CA 91770-3414
Phone (626) 280-6510

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

State licenses

LicenseStateTypeSpecialty
77131CAMDMarriage & Family Therapist
IMFT 62970CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1252022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1124351390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 E GRAVES AVE",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917703414",
            "telephone_number": "626-280-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 E GRAVES AVE",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917703414",
            "telephone_number": "626-280-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBOTA",
        "first_name": "JESSICA",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-04",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMFT 62970",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "77131",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosemead, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; 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.