Jennifer M Leydecker, MS

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

89389 Issued in CA

Practice address

650 Clark Way
Palo Alto, CA 94304-2300

Phone

(650) 617-3810

Fax

(650) 688-3669

NPI assigned

Sep 27, 2011

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

Credentials

Master of Science

State licenses

Practice roles

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.

• Youth Service Bureau of the YMCA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • South San Francisco, CA
  • NPI 1235712837
  NPD (past)

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1275816050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 CLARK WAY",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943042300",
            "telephone_number": "650-617-3810",
            "fax_number": "650-688-3669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 CLARK WAY",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943042300",
            "telephone_number": "650-617-3810",
            "fax_number": "650-688-3669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEYDECKER",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "89389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anhthu Nguyen Lewis, NP
• Chad York Lewis, MD, MPH
• David Bram Lewis, MD
• Erica Lewis, RD
• Jacquelyn Lewis, LMFT
• Alexander Li
• Allison Li
• Anjie Li, M.D.
• Carmen L Li, PHARMD, CDCES
• Carrie Marshall Li, N.P.

• Marriage & Family Therapist in Palo Alto, CA
• Providers in Palo Alto, 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 Jun 7, 2021; 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.