Individual provider Active NPI

Jennifer Marie Leath, PSYD

  • Clinical Psychologist
  • Newport Beach, CA
National Provider Identifier
1497953442
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY26109 Issued in CA
Practice address
1400 Quail St Ste 136
Newport Beach, CA 92660-2788
Phone
(949) 385-2775
Fax
(949) 336-3763
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY26109 CA Primary

Addresses

Primary practice location

1400 Quail St Ste 136
Newport Beach, CA 92660-2788

Mailing address

1400 Quail St Ste 136
Newport Beach, CA 92660-2788
Phone (949) 385-2775

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140626000113 CA Practitioner - Clinical Psychologist 3779714852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Psychological Services, Inc.Group PAC ID 2769747179, 8 clinicians

Practice addresses (Care Compare)

1400 Quail St
Suite 136
Newport Beach, CA 92660-2788
Phone (949) 385-2775

Merit-based Incentive Payment System (MIPS)

Final score
98.29 of 100Reported as group
Quality
90
Improvement activities
40
Cost
74.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY26109CAMDClinical Psychologist
26109CAMDDental Hygienist

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.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1497953442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 QUAIL ST STE 136",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602788",
            "telephone_number": "949-385-2775",
            "fax_number": "949-336-3763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 QUAIL ST STE 136",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602788",
            "telephone_number": "949-385-2775",
            "fax_number": "949-336-3763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEATH",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY26109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.