Active NPI
Skye Jensen
- Addiction (Substance Use Disorder) Counselor
- Covina, CA
National Provider Identifier
1144049537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- R1398460720
- Practice address
- 4626 N Grand Ave
Covina, CA 91724-2055 - Phone
- (626) 331-5316
- NPI assigned
- Oct 3, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R1398460720 | CA | Primary |
Addresses
Primary practice location
4626 N Grand Ave
Covina, CA 91724-2055
Mailing address
4626 N Grand Ave
Covina, CA 91724-2055
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
| License | State | Type | Specialty |
|---|---|---|---|
| R1398460720 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727913600000",
"number": "1144049537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4626 N GRAND AVE",
"city": "COVINA",
"state": "CA",
"postal_code": "917242055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4626 N GRAND AVE",
"city": "COVINA",
"state": "CA",
"postal_code": "917242055",
"telephone_number": "626-331-5316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "SKYE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-03",
"last_updated": "2024-10-03",
"certification_date": "2024-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R1398460720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.