Jacinda Mitchell, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

99700 Issued in CA

Practice address

1101 Fremont Ave Ste 101
South Pasadena, CA 91030-5704

Phone

(702) 340-5232

NPI assigned

Mar 21, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 15, 2024 through Feb 15, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1396044053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12764 NEWTON ST",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913424948",
            "telephone_number": "702-340-5232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 FREMONT AVE STE 101",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910305704",
            "telephone_number": "702-340-5232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JACINDA",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-21",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF66708",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "99700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minassian Rehab Management Inc
• Donna M Mince-Lewis, LCSW
• Jennifer Sofia Miranda Ramirez
• Mitchell C Latter M D Inc a Prof Corp
• Mitchell C Latter MD Inc a Prof Corp
• Roy Isamu Miyashiro, PHARM D
• Keisuke Mizuno, BSN, RN
• Davisha Moaning
• Heather Mommaerts
• Jacqueline Monteon

• Marriage & Family Therapist in South Pasadena, CA
• Providers in South Pasadena, 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 Jun 21, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.