Active NPI
Jason C Mechanick
- Case Manager/Care Coordinator
- Burbank, CA
National Provider Identifier
1316063415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 4306 W Victory Blvd
Burbank, CA 91505-1334 - Phone
- (818) 755-4950
- NPI assigned
- Mar 21, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSB29748 | CA | |
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
4306 W Victory Blvd
Burbank, CA 91505-1334
Mailing address
20151 Ingomar St
Winnetka, CA 91306-2518
Phone (818) 755-4950
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 |
|---|---|---|---|
| PSB29748 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190246400000",
"number": "1316063415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20151 INGOMAR ST",
"city": "WINNETKA",
"state": "CA",
"postal_code": "913062518",
"telephone_number": "818-755-4950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4306 W VICTORY BLVD",
"city": "BURBANK",
"state": "CA",
"postal_code": "915051334",
"telephone_number": "818-755-4950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MECHANICK",
"first_name": "JASON",
"middle_name": "C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-21",
"last_updated": "2007-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSB29748",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"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 Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.