Jennifer Mae Pruitt, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY24215 Issued in CA

Practice address

1215 W West Covina Pkwy
Suite 200
West Covina, CA 91790-2946

Phone

(562) 477-1161

NPI assigned

Aug 28, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Soultenders IncGroup PAC ID 6507170453, 113 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Soultenders, Inc.

  • Clinical Psychologist
  • Arcadia, CA
  • NPI 1164617007
  Medicare reassignment Care Compare group NPD
• Soultenders Psychological Services, Inc.

  • Clinical Social Worker
  • Arcadia, CA
  • NPI 1235810722
  NPD (past)

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305072000000",
    "number": "1497949937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 W WEST COVINA PKWY",
            "address_2": "SUITE 200",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902946",
            "telephone_number": "562-477-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 W WEST COVINA PKWY",
            "address_2": "SUITE 200",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902946",
            "telephone_number": "562-477-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "JENNIFER",
        "middle_name": "MAE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2011-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY24215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cary A Presant, M.D.
• Gilbert Prieto
• Prime RX West Covina Inc
• Primemed Medical Associates
• Project Raised
• Puente Hills Optometry Inc.
• Sandra Pulido
• Engracia Samia Punzalan, D.D.S.
• Orval Gomez Punzalan, DMD
• Jennifer Purificacion, LMFT

• Clinical Psychologist in West Covina, CA
• Providers in West Covina, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; 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.