Active NPI
Terri Jay
- Addiction (Substance Use Disorder) Counselor
- Los Angeles, CA
National Provider Identifier
1174848360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- C16811214
- Practice address
- 1730 W Olympic BL #300
Los Angeles, CA 90015 - Phone
- (213) 375-3830
- Fax
- (213) 553-1833
- NPI assigned
- Mar 31, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | C16811214 | CA | Primary |
Addresses
Primary practice location
1730 W Olympic BL #300
Los Angeles, CA 90015
Mailing address
1730 W Olympic BL #300
Los Angeles, CA 90015
Phone (213) 375-3830
Other practice location 1
1601 E 10th St
Long Beach, CA 90813-5035
Phone (562) 590-9010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174848360 | Medicaid | CA |
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 |
|---|---|---|---|
| C16811214 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Choices of Long Beach Inc | Past | Accepting new patients | |
| Apait Health Center | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community Health Clinic/Center
- Los Angeles, CA
- NPI 1912292285
-
- Mental Illness Community Based Residential Treatment Facility
- Long Beach, CA
- NPI 1346223781
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515024000000",
"number": "1174848360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1730 W OLYMPIC BL #300",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90015",
"telephone_number": "213-375-3830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1730 W OLYMPIC BL #300",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90015",
"telephone_number": "213-375-3830",
"fax_number": "213-553-1833"
}
],
"practiceLocations": [
{
"address_1": "1601 E 10th St",
"address_purpose": "LOCATION",
"city": "Long Beach",
"state": "CA",
"postal_code": "908135035",
"country_code": "US",
"telephone_number": "562-590-9010",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JAY",
"first_name": "TERRI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-31",
"last_updated": "2018-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "C16811214",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1174848360",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.