Jessica Leader

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

120691 Issued in CA

Practice address

11600 Washington PL Ste 204
Los Angeles, CA 90066-5068

Phone

(310) 689-6648

NPI assigned

Aug 8, 2020

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

Electronic endpoints 1

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 Mar 19, 2024 through Mar 19, 2028

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1596844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596844800000",
    "number": "1396355863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1769 GLENDON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245705",
            "telephone_number": "310-689-6648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 WASHINGTON PL STE 204",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900665068",
            "telephone_number": "310-689-6648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEADER",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-08",
        "last_updated": "2020-08-08",
        "certification_date": "2020-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "8173",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "120691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://secure.simplepractice.com/",
            "affiliation": "N",
            "address_1": "11600 Washington Pl Ste 204",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900665068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gary E Leach, MD
• Kelly Elizabeth Leach, PT, DPT
• Nadia Christine Leach, MMS, PA-C
• Robin Elaine Leach
• Travis Leach
• Kenneth Leaders
• Leading Public Health Enterprises, Inc.
• Ieti Leaea
• David Alexander Leaf, M.D.
• Leah Hiller Therapy

• Marriage & Family Therapist in Los Angeles, CA
• Providers in Los Angeles, 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 Aug 8, 2020; 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.