Jenny Yvonne Miranda

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

12450 Van Nuys Blvd
Pacoima, CA 91331-1391

Phone

(818) 896-1161

Fax

(818) 896-5069

NPI assigned

Jul 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1265632723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 SHASTA PL",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935506723",
            "telephone_number": "661-492-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12450 VAN NUYS BLVD",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913311391",
            "telephone_number": "818-896-1161",
            "fax_number": "818-896-5069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "JENNY",
        "middle_name": "YVONNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7068",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7420",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Pacoima, CA
• Providers in Pacoima, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; 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.