Individual provider Active NPI

Jaclyn Chu, LMFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1396424297
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT158491 Issued in CA
Practice address
1310 Wilshire Blvd
Los Angeles, CA 90017-1705
Phone
(213) 483-3000
NPI assigned
Jul 17, 2023
Last updated
Oct 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X AMFT140083 CA
Marriage & Family Therapist 106H00000X LMFT158491 CA Primary

Addresses

Primary practice location

1310 Wilshire Blvd
Los Angeles, CA 90017-1705

Mailing address

1310 Wilshire Blvd
Los Angeles, CA 90017-1705
Phone (213) 483-3000

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
I20251118003116 CA Practitioner - Marriage and Family Therapist 0648761569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Special Service for Groups IncGroup PAC ID 2769396886, 61 clinicians

Practice addresses (Care Compare)

1310 Wilshire Blvd
Los Angeles, CA 90017-1705
Phone (213) 483-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AMFT140083CAMDMarriage & Family Therapist
LMFT158491CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Special Service for Groups, Inc. CurrentSince Oct 2, 2025 Accepting new patients
Special Service for Groups, Inc. Current Accepting new patients
Special Service for Groups, Inc. CurrentSince Oct 2, 2025 Accepting new patients

Locations

1310 Wilshire Blvd
Los Angeles, CA 90017
Phone (213) 483-3000

905 E 8th St
Los Angeles, CA 90021
Phone (213) 553-1800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1396424297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171705",
            "telephone_number": "213-483-3000",
            "fax_number": "213-483-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171705",
            "telephone_number": "213-483-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHU",
        "first_name": "JACLYN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT140083",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT158491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.