Individual provider Active NPI

Rhonda Lee Jessum, PH.D.

  • Clinical Psychologist
  • Malibu, CA
National Provider Identifier
1457400400
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY15775 Issued in CA
Practice address
3198 Gorge Rd
Malibu, CA 90265-3518
Phone
(818) 880-0250
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY15775 CA Primary

Addresses

Primary practice location

3198 Gorge Rd
Malibu, CA 90265-3518

Mailing address

PO Box 1027
Malibu, CA 90265-1027
Phone (818) 880-0250

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
I20060224000643 CA Practitioner - Clinical Psychologist 4587670799 Practice locations: Malibu, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3198 Gorge Rd
Malibu, CA 90265-3518
Phone (818) 880-0250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY15775CAMDClinical Psychologist
15775CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Our Common Heart CurrentSince Jan 19, 2025 Accepting new patients
Health Capacity, PC Clinical Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1457400400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1027",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902651027",
            "telephone_number": "818-880-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3198 GORGE RD",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902653518",
            "telephone_number": "818-880-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSUM",
        "first_name": "RHONDA",
        "middle_name": "LEE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY15775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malibu, CA

Sources for this page

Verify at the official NPI Registry.