Individual provider Active NPI

Jessica Raye Carr, MD

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1265069009
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A180185 Issued in CA
Practice address
1990 S Bundy Dr Ste 385
Los Angeles, CA 90025-5245
Phone
(310) 243-6477
NPI assigned
Mar 23, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A180185 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1990 S Bundy Dr Ste 385
Los Angeles, CA 90025-5245

Mailing address

4114 Alla Rd
Los Angeles, CA 90066-5702
Phone (310) 243-6477

Other practice location 1

4114 Alla Rd
Los Angeles, CA 90066-5702
Phone (310) 243-6477

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220615002382 CA Order and Referring Only - PsychiatryPractitioner - Psychiatry 5395124747

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A180185CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1265069009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 ALLA RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900665702",
            "telephone_number": "310-243-6477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 S BUNDY DR STE 385",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255245",
            "telephone_number": "310-243-6477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4114 Alla Rd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900665702",
            "country_code": "US",
            "telephone_number": "310-243-6477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARR",
        "first_name": "JESSICA",
        "middle_name": "RAYE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-23",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A180185",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.