Individual provider Active NPI

Terri Jay

  • Addiction (Substance Use Disorder) Counselor
  • Los Angeles, CA
National Provider Identifier
1174848360
Registry record updated Jan 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
C16811214 Issued in CA
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

Updated by the provider on Jan 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1174848360MedicaidCA

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
C16811214CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.