Jacielle Jeravey Acosta, LMFT
Individual provider Active NPI Marriage & Family Therapist · Pasadena, CA
NPI 1215478144 · NPPES record last updated Jun 20, 2023
Key facts
- NPI
- 1215478144
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 122658 (CA)
- Practice address
- 2550 E Foothill Blvd
Pasadena, CA 91107-3406 - Phone
- (626) 744-5230
- NPI assigned
- Mar 10, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95829 | CA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Clinics | Current |
Accepting new patients | |
| Pacific Clinics | Past | Accepting new patients | |
| Pacific Clinics | Past | Accepting new patients |
Locations
251 Llewellyn Ave
Campbell, CA 95008
Phone (408) 364-4083
66 Hurlbut St
Pasadena, CA 91105
2550 E Foothill Blvd
Pasadena, CA 91107
Phone (626) 744-5242
1020 S Arroyo Pkwy
Pasadena, CA 91105
Phone (626) 403-2794
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 95829 | CA | |
| Marriage & Family Therapist | 106H00000X | 122658 | CA | Yes |
Addresses
Primary practice location
2550 E Foothill Blvd
Pasadena, CA 91107-3406
Mailing address
2550 E Foothill Blvd
Pasadena, CA 91107-3406
Phone (626) 744-5230
Other providers in Pasadena, CA
- Carla Jannet Acosta
- Carolina Elisabeth Acosta
- Eileen Nicole Acosta
- Elia Acosta
- Francisca M Acosta
- Jennifer Acosta
- Michael Thomas Acosta
- Nicole Marie Acosta
- Acro Consultancy Services a Psychological Corporation
- Actus ABA LLC
All providers in Pasadena, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.