Active NPI
Jared Nilsson
- Marriage & Family Therapist
- Bishop, CA
National Provider Identifier
1417760141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 1360 N Main St Ste 124
Bishop, CA 93514-3013 - Phone
- (760) 874-3613
- NPI assigned
- Jan 28, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | Primary |
Addresses
Primary practice location
1360 N Main St Ste 124
Bishop, CA 93514-3013
Mailing address
1360 N. Main Ste Suite 124
Bishop, CA 93514
Phone (760) 937-1454
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738022400000",
"number": "1417760141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1360 N. MAIN STE SUITE 124",
"city": "BISHOP",
"state": "CA",
"postal_code": "93514",
"telephone_number": "760-937-1454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1360 N MAIN ST STE 124",
"city": "BISHOP",
"state": "CA",
"postal_code": "935143013",
"telephone_number": "760-874-3613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NILSSON",
"first_name": "JARED",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-01-28",
"last_updated": "2025-01-28",
"certification_date": "2025-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bishop, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.