Active NPI
Jessica Peters
- Mental Health Counselor
- San Carlos, CA
National Provider Identifier
1457785917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 74280
- Practice address
- 610 Elm St
San Carlos, CA 94070-8401 - Phone
- (650) 591-9623
- NPI assigned
- Sep 2, 2013
- Last updated
- Sep 2, 2013
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 74280 | CA | Primary |
Addresses
Primary practice location
610 Elm St
San Carlos, CA 94070-8401
Mailing address
PO Box 720161
San Francisco, CA 94172-0161
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 7, 2025 through Feb 7, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74280 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378080000000",
"number": "1457785917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 720161",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941720161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 ELM ST",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940708401",
"telephone_number": "650-591-9623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-02",
"last_updated": "2013-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "74280",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Carlos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.