Individual provider Active NPI

Jessica Elaine Bushmeyer, M.S.

  • Marriage & Family Therapist
  • Covina, CA
National Provider Identifier
1295101061
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT96382 Issued in CA
Practice address
510 S 2ND Ave
Covina, CA 91723-3017
Phone
(626) 974-8123
Fax
(626) 974-8198
NPI assigned
Aug 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT96382 CA Primary

Addresses

Primary practice location

510 S 2ND Ave
Covina, CA 91723-3017

Mailing address

824 E Griffith St
Azusa, CA 91702-6290
Phone (626) 224-1532

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LMFT96382CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Public Health Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jessicawilson-socialmodel@lacsapc.netsmartdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1295101061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 E GRIFFITH ST",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917026290",
            "telephone_number": "626-224-1532",
            "fax_number": "626-974-8198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S 2ND AVE",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917233017",
            "telephone_number": "626-974-8123",
            "fax_number": "626-974-8198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHMEYER",
        "first_name": "JESSICA",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-17",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT96382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.