Active NPI
Jasey Rose Stetser, MA
- Mental Health Counselor
- San Jose, CA
National Provider Identifier
1255036836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 10819
- Practice address
- 350 E Taylor St Apt 2212
San Jose, CA 95112-3149 - Phone
- (408) 796-2140
- NPI assigned
- Apr 3, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 10819 | CA | Primary |
Addresses
Primary practice location
350 E Taylor St Apt 2212
San Jose, CA 95112-3149
Mailing address
191 Lighthouse Ave Ste A5
Monterey, CA 93940-1704
Phone (831) 737-8295
Other names 1
- Jasey Rose Simmons
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10819 | CA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Liana Shapiro-Lee Licensed Marriage and Family Therapist | Current | Accepting new patients |
Locations
191 Lighthouse Ave
Ste A5
Monterey, CA 93940
Phone (831) 221-0088
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 and National Provider Directory roles.
-
- Adult Mental Health Clinic/Center
- Monterey, CA
- NPI 1730659103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704758400000",
"number": "1255036836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "191 LIGHTHOUSE AVE STE A5",
"city": "MONTEREY",
"state": "CA",
"postal_code": "939401704",
"telephone_number": "831-737-8295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 E TAYLOR ST APT 2212",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951123149",
"telephone_number": "408-796-2140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STETSER",
"first_name": "JASEY",
"middle_name": "ROSE",
"name_prefix": "Mrs.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-03",
"last_updated": "2024-01-09",
"certification_date": "2024-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "10819",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JASEY",
"last_name": "SIMMONS",
"middle_name": "ROSE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.