Individual provider Active NPI

Jessica Lynne Bodden, MD

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1396327656
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A192200 Issued in CA
Practice address
2116 Arlington Ave
Los Angeles, CA 90018-1353
Phone
(323) 334-9000
NPI assigned
Apr 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X A192200 CA Primary

Addresses

Primary practice location

2116 Arlington Ave
Los Angeles, CA 90018-1353

Mailing address

2116 Arlington Ave
Los Angeles, CA 90018-1353
Phone (323) 334-9000

Other practice location 1

1000 W Carson St
Torrance, CA 90502-2004
Phone (424) 306-4000

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250226002942 CA Practitioner - Psychiatry 6800255324

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of California, Geffen School of Medicine, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2116 Arlington Ave
Suite 100
Los Angeles, CA 90018-1300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A192200CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The People Concern CurrentSince Dec 22, 2024 Accepting new patients
The People Concern Current Accepting new patients
The People Concern CurrentSince Dec 22, 2024 Accepting new patients

Locations

2116 Arlington Ave
Ste 100
Los Angeles, CA 90018

1751 Cloverfield Blvd
Santa Monica, CA 90404
Phone (310) 450-0650

Organizations & group practices 3

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": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1396327656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 ARLINGTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900181353",
            "telephone_number": "323-334-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 ARLINGTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900181353",
            "telephone_number": "323-334-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W Carson St",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905022004",
            "country_code": "US",
            "telephone_number": "424-306-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODDEN",
        "first_name": "JESSICA",
        "middle_name": "LYNNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-26",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A192200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.