Individual provider Active NPI

Jennifer Lee Pfeuffer, PSYD

  • Mental Health Counselor
  • San Diego, CA
National Provider Identifier
1134763972
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
10717 Camino Ruiz Ste 207
San Diego, CA 92126-2381
Phone
(858) 695-2211
NPI assigned
Nov 5, 2019
Last updated
Feb 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary
Counseling Psychologist 103TC1900X PS018550 PA

Addresses

Primary practice location

10717 Camino Ruiz Ste 207
San Diego, CA 92126-2381

Mailing address

10717 Camino Ruiz Ste 207
San Diego, CA 92126-2381
Phone (858) 695-2211

Other practice location 1

246 Friendship Cir
Beaver, PA 15009-9704
Phone (724) 775-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS018550PAMDCounseling Psychologist
33363CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Research Foundation Inc PastSince Jan 31, 2021 Accepting new patients
Community Research Foundation Inc PastSince Jan 31, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1134763972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10717 CAMINO RUIZ STE 207",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262381",
            "telephone_number": "858-695-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10717 CAMINO RUIZ STE 207",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262381",
            "telephone_number": "858-695-2211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "246 Friendship Cir",
            "address_purpose": "LOCATION",
            "city": "Beaver",
            "state": "PA",
            "postal_code": "150099704",
            "country_code": "US",
            "telephone_number": "724-775-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PFEUFFER",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-05",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PA",
            "license": "PS018550",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.