Louis Jenkins, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY6079 Issued in CA

Practice address

11130 Anderson St
Ste 117
Loma Linda, CA 92354-2802

Phone

(909) 558-8752

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Faculty Physicians and Surgeons of Llusm

  • Psychologist
  • Loma Linda, CA
  • NPI 1487603924
  NPD (past)
• Faculty Physicians and Surgeons of Llusm

  • Family Medicine Physician
  • Moreno Valley, CA
  • NPI 1558788331
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154401552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54701 FILE NUMBER",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900744701",
            "telephone_number": "909-558-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11130 ANDERSON ST",
            "address_2": "STE 117",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542802",
            "telephone_number": "909-558-8752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "LOUIS",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY6079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY060790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Akinlolu Tolulope Jegede, DDS
• Omar Jeiroudi, MD
• Rami Ramzi Jekki, D.D.S.
• Forrest C. Jellison, M.D.
• Leo C Jeng, M.D.
• Soh Jeon
• Won Jin Jeon, MD
• Ye Jin Jeon, MD
• Jennifer Jiyoon Jeong, DNP, PMHNP-BC
• Seongchan Jeong

• Clinical Psychologist in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.