Active NPI
Jeanette H. Merkel, PH.D., M.F.T.
- Clinical Psychologist
- Thousand Oaks, CA
National Provider Identifier
1285717041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY13983
- Practice address
- 141 Duesenberg Dr
Suite 2
Thousand Oaks, CA 91362 - Phone
- (805) 378-7205
- Fax
- (805) 497-4647
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY13983 | CA | Primary |
| Marriage & Family Therapist | 106H00000X | MFC24039 | CA |
Addresses
Primary practice location
141 Duesenberg Dr
Suite 2
Thousand Oaks, CA 91362
Mailing address
141 Duesenberg Dr
Suite 2
Thousand Oaks, CA 91362
Phone (805) 378-7205
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY139830 | Medicaid | CA |
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120110000321 | CA | Practitioner - Clinical Psychologist | 5395911531 | Practice locations: Westlake Village, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
141 Duesenberg Dr
Suite 2
Westlake Village, CA 91362-3467
Phone (805) 378-7205
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY13983 | CA | MD | Clinical Psychologist |
| MFC24039 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287100800000",
"number": "1285717041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 DUESENBERG DR",
"address_2": "SUITE 2",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "91362",
"telephone_number": "805-378-7205",
"fax_number": "805-497-4647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 DUESENBERG DR",
"address_2": "SUITE 2",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "91362",
"telephone_number": "805-378-7205",
"fax_number": "805-497-4647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERKEL",
"first_name": "JEANETTE",
"middle_name": "H.",
"name_prefix": "Dr.",
"credential": "PH.D., M.F.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2010-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY13983",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC24039",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY139830",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Thousand Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.