Jennifer Anne Butler, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

341179 Issued in CA

Practice address

10559 Jefferson Blvd
Culver City, CA 90232-3526

Phone

(310) 935-0135

NPI assigned

Mar 29, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Group practices

Alcott Center for Mental Health ServicesGroup PAC ID 2062544554, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Alcott Center for Mental Health Services

  • Adult Mental Health Clinic/Center
  • Culver City, CA
  • NPI 1942338090
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1144596586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10549 JEFFERSON BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902323513",
            "telephone_number": "310-785-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10559 JEFFERSON BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902323526",
            "telephone_number": "310-935-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-29",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "108093",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "341179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Burks
• Patricia Anne Burnham, MA
• Kristin Bustamante
• Renee C Bustamante
• Isabel Bustos
• John Martin Butler, D.C.
• Laquoia Prechaun Butler
• Nicola Butler
• Allyson Byers
• Rebecca Ann Byler

• Psychologist in Culver City, CA
• Providers in Culver City, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.