Individual provider Active NPI

Jessica Joyce Carey, PSYD

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1205967270
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
28434 Issued in CA
Practice address
4401 Crenshaw Blvd
Los Angeles, CA 90043-1227
Phone
(323) 290-8366
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 28434 CA Primary

Addresses

Primary practice location

4401 Crenshaw Blvd
Los Angeles, CA 90043-1227

Mailing address

3031 S Vermont Ave
Los Angeles, CA 90007-3033
Phone (323) 373-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230125002431 CA Practitioner - Clinical Psychologist 7416328653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Executive Mental Health, IncGroup PAC ID 0345209102, 47 clinicians

Practice addresses (Care Compare)

11835 W Olympic Blvd
Suite 1270E
Los Angeles, CA 90064-5053
Phone (310) 273-4843

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brian Wu MD PHD Inc CurrentSince Jan 23, 2023 Accepting new patients
Wellnest Emotional Health & Wellness PastSince Sep 1, 2019 Accepting new patients

Locations

11835 W Olympic Blvd
Ste 1270E
Los Angeles, CA 90064
Phone (310) 273-4843

16890 Green Tree Blvd
Victorville, CA 92395
Phone (310) 273-4843

Organizations & group practices 3

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1205967270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900073033",
            "telephone_number": "323-373-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900431227",
            "telephone_number": "323-290-8366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAREY",
        "first_name": "JESSICA",
        "middle_name": "JOYCE",
        "name_prefix": "Ms.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "28434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.