Individual provider Active NPI

Jihan Amer

  • Mental Health Counselor
  • Santa Cruz, CA
National Provider Identifier
1215308549
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
125407 Issued in CA
Practice address
300 Harvey West Blvd
Santa Cruz, CA 95060-2103
Phone
(831) 425-8132
Fax
(831) 425-8132
NPI assigned
Oct 13, 2015
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 87494 CA
Mental Health Counselor 101YM0800X 125407 CA Primary

Addresses

Primary practice location

300 Harvey West Blvd
Santa Cruz, CA 95060-2103

Mailing address

407 Grenham Rd
Greensboro, NC 27455-9201
Phone (831) 258-9298

Other identifiers 1

IdentifierTypeStateIssuer
125407OtherCALMFT#

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
I20240522003858 CA Practitioner - Marriage and Family Therapist 9739521782 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
87494CAMDPharmacist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1215308549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 GRENHAM RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274559201",
            "telephone_number": "831-258-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HARVEY WEST BLVD",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950602103",
            "telephone_number": "831-425-8132",
            "fax_number": "831-425-8132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMER",
        "first_name": "JIHAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-13",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "87494",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "125407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMFT#",
            "identifier": "125407",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.