Organization Active NPI

JBL Mental Health Nursing Corp

  • Psychiatric/Mental Health Nurse Practitioner
  • Glendora, CA
National Provider Identifier
1245053933
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
JBL MENTAL HEALTH NURSING CORP
Practice address
415 W Route 66 Ste 202
Glendora, CA 91740-4335
Phone
(626) 963-4467
NPI assigned
Nov 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Authorized official

Name
Mr. Jason Brett Larick, PMHNPNPI 1356190193
Title
Nurse Practitioner
Phone
(626) 963-4467

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

415 W Route 66 Ste 202
Glendora, CA 91740-4335

Mailing address

415 W Route 66 Ste 202
Glendora, CA 91740-4335
Phone (626) 963-4467

National Provider Directory

National Provider Directory

Locations

415 W Route 66
Ste 202
Glendora, CA 91740

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1730419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730419200000",
    "number": "1245053933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W ROUTE 66 STE 202",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404335",
            "telephone_number": "626-963-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W ROUTE 66 STE 202",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404335",
            "telephone_number": "626-963-4467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JBL MENTAL HEALTH NURSING CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-01",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A",
        "authorized_official_last_name": "LARICK",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "BRETT",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "626-963-4467",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; 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.