Individual provider Active NPI

Jean Rose Pana

  • Marriage & Family Therapist
  • Laguna Hills, CA
National Provider Identifier
1164949640
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
113761 Issued in CA
Practice address
23293 S Pointe Dr
Laguna Hills, CA 92653-1441
Phone
(949) 989-2620
NPI assigned
Aug 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Counselor 225C00000X
Rehabilitation Practitioner 225400000X CA
Marriage & Family Therapist 106H00000X 113761 CA Primary

Addresses

Primary practice location

23293 S Pointe Dr
Laguna Hills, CA 92653-1441

Mailing address

23293 S Pointe Dr
Laguna Hills, CA 92653-1441
Phone (714) 588-0818

Other practice location 1

2000 Tyler Ave
South El Monte, CA 91733-3543
Phone (714) 390-7388

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
113761CAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1164949640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23293 S POINTE DR",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531441",
            "telephone_number": "714-588-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23293 S POINTE DR",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531441",
            "telephone_number": "949-989-2620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Tyler Ave",
            "address_purpose": "LOCATION",
            "city": "South El Monte",
            "state": "CA",
            "postal_code": "917333543",
            "country_code": "US",
            "telephone_number": "714-390-7388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANA",
        "first_name": "JEAN ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "113761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.