Individual provider Active NPI

Jesse Lee Tatum, LMFT, LPCC

  • Marriage & Family Therapist
  • San Luis Obispo, CA
National Provider Identifier
1487276911
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT152548 Issued in CA
Practice address
1171 Toro St Ste C
San Luis Obispo, CA 93401-3356
Phone
(805) 550-4380
NPI assigned
May 6, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT152548 CA Primary
Professional Counselor 101YP2500X LPCC19466 CA

Addresses

Primary practice location

1171 Toro St Ste C
San Luis Obispo, CA 93401-3356

Mailing address

1171 Toro St Ste C
San Luis Obispo, CA 93401-3356
Phone (805) 550-4380

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPCC19466CAMDProfessional Counselor
LMFT152548CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1487276911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 TORO ST STE C",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013356",
            "telephone_number": "805-550-4380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 TORO ST STE C",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013356",
            "telephone_number": "805-550-4380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "JESSE",
        "middle_name": "LEE",
        "credential": "LMFT, LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-06",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT152548",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "LPCC19466",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.