Individual provider Active NPI

Jennifer Laura Owens

  • Professional Counselor
  • Diamond Springs, CA
National Provider Identifier
1346470671
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
12201 Issued in CA
Practice address
4250 Fowler LN Ste 204
Diamond Springs, CA 95619-9782
Phone
(530) 626-3105
NPI assigned
Jul 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 12201 CA Primary

Addresses

Primary practice location

4250 Fowler LN Ste 204
Diamond Springs, CA 95619-9782

Mailing address

PO Box 1987
Diamond Springs, CA 95619-1987

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251112002058 CA Practitioner - Mental Health Counselor 4082105556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12201CAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Mental Health CurrentSince Oct 3, 2025 Accepting new patients
Sierra Child and Family Services PastSince Jan 3, 2021 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 2

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": "1248134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1346470671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1987",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956191987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 FOWLER LN STE 204",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956199782",
            "telephone_number": "530-626-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "JENNIFER",
        "middle_name": "LAURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-21",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "12201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Springs, CA

Sources for this page

Verify at the official NPI Registry.