Individual provider Active NPI

Jane Odegard, PSYD, LMFT, LPCC

  • Marriage & Family Therapist
  • Monterey, CA
National Provider Identifier
1417074659
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT78630 Issued in CA
Practice address
604 Pearl St
Monterey, CA 93940-3070
Phone
(831) 649-4522
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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 LMFT78630 CA Primary
Mental Health Counselor 101YM0800X LPCC1160 CA

Addresses

Primary practice location

604 Pearl St
Monterey, CA 93940-3070

Mailing address

17558 Cross Rd
Prunedale, CA 93907-1571
Phone (831) 663-6669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPCC1160CAMDMental Health Counselor
LMFT78630CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1417074659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17558 CROSS RD",
            "city": "PRUNEDALE",
            "state": "CA",
            "postal_code": "939071571",
            "telephone_number": "831-663-6669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 PEARL ST",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939403070",
            "telephone_number": "831-649-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODEGARD",
        "first_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "PSYD, LMFT, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT78630",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LPCC1160",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.