Individual provider Active NPI

Jaime Dunham, LMFT

  • Marriage & Family Therapist
  • Long Beach, CA
National Provider Identifier
1144479536
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
94433 Issued in CA
Practice address
3620 Long Beach Blvd Ste C6
Long Beach, CA 90807-6011
Phone
(562) 248-6638
NPI assigned
Sep 10, 2008
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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 IMF73072 CA
Marriage & Family Therapist 106H00000X 94433 CA Primary

Addresses

Primary practice location

3620 Long Beach Blvd Ste C6
Long Beach, CA 90807-6011

Mailing address

3620 Long Beach Blvd Ste C6
Long Beach, CA 90807-6011
Phone (562) 248-6638

Other identifiers 1

IdentifierTypeStateIssuer
1669560488MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240226000564 CA Practitioner - Marriage and Family Therapist 1850736240 Practice locations: Long Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3620 Long Beach Blvd
Suite C6
Long Beach, CA 90807-4022

3620 Long Beach Blvd
Suite C6
Long Beach, CA 90807-6011
Phone (562) 248-6638

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IMF73072CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Belmont Psychological Services, a Psychology Corporation PastSince Nov 9, 2021 Accepting new patients

Organizations & group practices 1

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": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1144479536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 LONG BEACH BLVD STE C6",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908076011",
            "telephone_number": "562-248-6638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 LONG BEACH BLVD STE C6",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908076011",
            "telephone_number": "562-248-6638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNHAM",
        "first_name": "JAIME",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF73072",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "94433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669560488",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.