Active NPI
Jessica Federowicz
- Clinical Psychologist
- Temecula, CA
National Provider Identifier
1528449477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY-1969
- Practice address
- PO Box 890133
Temecula, CA 92589-0133 - Phone
- (716) 430-6999
- NPI assigned
- Jun 17, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MHC-411 | HI | |
| Behavior Analyst | 103K00000X | |||
| Clinical Psychologist | 103TC0700X | PSY-1969 | HI | Primary |
Addresses
Primary practice location
PO Box 890133
Temecula, CA 92589-0133
Mailing address
33755 Pauba Rd
Temecula, CA 92592-9349
Phone (716) 430-6999
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
| License | State | Type | Specialty |
|---|---|---|---|
| MHC-411 | HI | MD | Mental Health Counselor |
| PSY-1969 | HI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738281600000",
"number": "1528449477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33755 PAUBA RD",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925929349",
"telephone_number": "716-430-6999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 890133",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925890133",
"telephone_number": "716-430-6999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDEROWICZ",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-17",
"last_updated": "2025-01-31",
"certification_date": "2025-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "HI",
"license": "MHC-411",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "HI",
"license": "PSY-1969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temecula, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.