Jenica R Ottero – Clinical Psychologist

Key facts

NPI: 1467089003
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Psychologist 103TC0700X
License: PSY31661 (CA)
Practice address: 244 California St Ste 300
San Francisco, CA 94111-4311
Phone: (510) 999-6241
NPI assigned: Mar 24, 2020
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Two Chairs Behavioral Health Group, a Psychology Corporation Professional Counselor · San Francisco, CA · NPI 1629515705

NPD (past)

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
PSY31661	CA	MD	Clinical Psychologist

Practice roles

Organization	Specialty	Status	New patients
Two Chairs Behavioral Health Group, a Psychology Corporation		Past since Mar 29, 2020	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Psychologist	103TC0700X	PSY31661	CA	Yes

Addresses

Primary practice location

244 California St Ste 300
San Francisco, CA 94111-4311

Mailing address

2330 Webster St Apt 744
Oakland, CA 94612-3108
Phone (303) 514-2558

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 24, 2020.

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1467089003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 WEBSTER ST APT 744",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123108",
            "telephone_number": "303-514-2558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 CALIFORNIA ST STE 300",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941114311",
            "telephone_number": "510-999-6241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTERO",
        "first_name": "JENICA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY31661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

All providers in San Francisco, CA · Clinical Psychologist in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.