Active NPI
Jennifer Anne Evans, LMFT
- Marriage & Family Therapist
- Burbank, CA
National Provider Identifier
1295035905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT81067
- Practice address
- 1108 N Hollywood Way
Burbank, CA 91505-2527 - Phone
- (818) 429-7854
- Fax
- (818) 301-7479
- NPI assigned
- Oct 27, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IMFT 61713 | CA | |
| Marriage & Family Therapist | 106H00000X | LMFT81067 | CA | Primary |
Addresses
Primary practice location
1108 N Hollywood Way
Burbank, CA 91505-2527
Mailing address
1108 N Hollywood Way
Burbank, CA 91505-2527
Phone (818) 429-7854
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMFT 61713 | CA | MD | Mental Health Counselor |
| LMFT81067 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samantha Markman LMFT Inc. | Marriage & Family Therapist | Past | Accepting new patients |
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.
-
- Marriage & Family Therapist
- Newhall, CA
- NPI 1558925800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405296000000",
"number": "1295035905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1108 N HOLLYWOOD WAY",
"city": "BURBANK",
"state": "CA",
"postal_code": "915052527",
"telephone_number": "818-429-7854",
"fax_number": "818-301-7479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1108 N HOLLYWOOD WAY",
"city": "BURBANK",
"state": "CA",
"postal_code": "915052527",
"telephone_number": "818-429-7854",
"fax_number": "818-301-7479"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "JENNIFER",
"middle_name": "ANNE",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-27",
"last_updated": "2014-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "IMFT 61713",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "LMFT81067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burbank, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.