Jennifer Lynn Codega, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

103851 Issued in CA

Practice address

100 W Foothill Blvd Ste 204
San Dimas, CA 91773-1171

Phone

(909) 473-4487

Fax

(310) 756-1225

NPI assigned

Feb 1, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550448000000",
    "number": "1245739507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W FOOTHILL BLVD STE 104",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731170",
            "telephone_number": "909-551-4672",
            "fax_number": "310-756-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W FOOTHILL BLVD STE 204",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731171",
            "telephone_number": "909-473-4487",
            "fax_number": "310-756-1225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7365 Carnelian St Ste 132",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917301100",
            "country_code": "US",
            "telephone_number": "909-551-4672",
            "fax_number": "310-756-1225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CODEGA",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-01",
        "last_updated": "2019-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "103851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in San Dimas, CA
• Providers in San Dimas, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; 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.