Jordan Gabriel Pelot, M.A., LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

93693 Issued in CA

Practice address

2901 Shattuck Ave
Suite E.
Berkeley, CA 94705-1808

Phone

(510) 698-2579

NPI assigned

Sep 6, 2011

Sex

Male

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Bay Area Center for Psychotherapy

  • Marriage & Family Therapist
  • Sebastopol, CA
  • NPI 1033634928
  Medicare reassignment NPD Authorized official
• Alameda Health System

  • Surgery Physician
  • Oakland, CA
  • NPI 1740332931
  Medicare reassignment NPD
• Alameda Health System

  • Federally Qualified Health Center (FQHC)
  • Newark, CA
  • NPI 1497956288
  NPD

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1306127246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3943",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947030943",
            "telephone_number": "510-698-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 SHATTUCK AVE",
            "address_2": "SUITE E.",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051808",
            "telephone_number": "510-698-2579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELOT",
        "first_name": "JORDAN",
        "middle_name": "GABRIEL",
        "name_prefix": "Mr.",
        "credential": "M.A., LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-06",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "93693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamela Monique Peart, PSYD
• Renee Peck
• Pediatric Psychology Partners PC
• Cynthia Peery, PTA
• Robert Pelletier
• Rachael Arline Peltz, PH.D.
• Diana Pena, PH.D.
• Rafael Pena
• Penelope S.Yip D.D.S., Inc.
• Peninsula Counseling and Consulting Inc Ryan Gardner

• Marriage & Family Therapist in Berkeley, CA
• Providers in Berkeley, 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 Sep 21, 2016; 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.

Verify at the official NPI Registry.