Individual provider Active NPI

Jessica Wang, MD

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1467156547
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A196560 Issued in CA
Practice address
2010 Zonal Ave # 1P10
Los Angeles, CA 90033-1026
Phone
(323) 409-5555
NPI assigned
Mar 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A196560 CA
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X A196560 CA Primary

Addresses

Primary practice location

2010 Zonal Ave # 1P10
Los Angeles, CA 90033-1026

Mailing address

2010 Zonal Ave # 1P10
Los Angeles, CA 90033-1026

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240529003256 CA Order and Referring Only - PsychiatryPractitioner - Psychiatry 8325480890

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A196560CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1467156547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 ZONAL AVE # 1P10",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 ZONAL AVE # 1P10",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331026",
            "telephone_number": "323-409-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "JESSICA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-30",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A196560",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A196560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.