Individual provider Active NPI

Lavelle Dawn Jacobson, LMFT

  • Marriage & Family Therapist
  • Palm Desert, CA
National Provider Identifier
1427693886
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
116178 Issued in CA
Practice address
43585 Monterey Ave Ste 8
Palm Desert, CA 92260-9400
Phone
(760) 776-0670
NPI assigned
Nov 8, 2019
Last updated
Nov 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 116178 CA Primary

Addresses

Primary practice location

43585 Monterey Ave Ste 8
Palm Desert, CA 92260-9400

Mailing address

43585 Monterey Ave Ste 8
Palm Desert, CA 92260-9400
Phone (760) 776-0670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 19, 2025 through Jun 19, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
116178CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1427693886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43585 MONTEREY AVE STE 8",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922609400",
            "telephone_number": "760-776-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43585 MONTEREY AVE STE 8",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922609400",
            "telephone_number": "760-776-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "LAVELLE",
        "middle_name": "DAWN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-08",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "116178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

Verify at the official NPI Registry.