Jessica Gonzalez Haugen

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1268 Issued in CA

Practice address

1701 E Cesar E Chavez Ave Ste 230
Los Angeles, CA 90033-2496

Phone

(323) 226-5789

NPI assigned

Jun 22, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

College of Osteo Med of the Pacific at Pomona, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Care Specialists Medical CorporationGroup PAC ID 6709834112, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health White Memorial Hospital, Los Angeles, CA, CCN 050103

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: jessica.haugen.2@24668.direct.athenahealth.com

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.

• Family Care Specialists Medical Corporation

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1649223777
  Medicare reassignment Care Compare group NPD
• Family Care Specialists Medical Corporation

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1942255195
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• White Memorial Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1215927470
  Care Compare affiliation

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

{
    "created_epoch": "1561161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1487215372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 E CESAR E CHAVEZ AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332414",
            "telephone_number": "323-260-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E CESAR E CHAVEZ AVE STE 230",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332496",
            "telephone_number": "323-226-5789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGEN",
        "first_name": "JESSICA",
        "middle_name": "GONZALEZ",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-22",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "1268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "POSTGRADUATE TRAINING LICENSE",
            "identifier": "1268",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Hatzakis
• Nikolaos Hatzakis
• Hatzolah of Los Angeles
• CHI Le Hau, PHARMD
• Cecily Haubner
• Kiel Kimberley Haugen, M.D.
• William Haugland
• Carolyn Elizabeth Haunschild, M.D.
• Martin Hauptschein, M.D.
• Elizabeth Hopkins Haury

• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.