Active NPI
Jean Rose Pana
- Marriage & Family Therapist
- Laguna Hills, CA
National Provider Identifier
1164949640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 113761
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 113761 | CA | MD | Social 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.