Individual provider Active NPI

Jaydon Landeros

  • Professional Counselor
  • Whittier, CA
National Provider Identifier
1154130912
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
17490 Issued in CA
Practice address
15111 Whittier Blvd Ste 250
Whittier, CA 90603-3307
Phone
(833) 587-1784
NPI assigned
Jan 6, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 17490 CA Primary

Addresses

Primary practice location

15111 Whittier Blvd Ste 250
Whittier, CA 90603-3307

Mailing address

15111 Whittier Blvd Ste 250
Whittier, CA 90603-3307
Phone (833) 587-1784

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
17490CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Development of California PC CurrentSince Jan 12, 2025 Accepting new patients

Locations

15111 Whittier Blvd
Ste 250
Whittier, CA 90603
Phone (323) 461-3161

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1736121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1154130912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15111 WHITTIER BLVD STE 250",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906033307",
            "telephone_number": "833-587-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15111 WHITTIER BLVD STE 250",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906033307",
            "telephone_number": "833-587-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDEROS",
        "first_name": "JAYDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "17490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.