Jesse Samson-Jacob Bernal, MA, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

84944 Issued in CA

Practice address

1712 Corson St
Pasadena, CA 91106-1606

Phone

(323) 326-8291

NPI assigned

Jan 21, 2011

Last updated

Oct 24, 2023By the provider in NPPES

Sex

Male

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Soultenders, Inc.

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

  • Clinical Social Worker
  • Arcadia, CA
  • NPI 1235810722
  NPD

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

{
    "created_epoch": "1295568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1548565542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2212",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911022212",
            "telephone_number": "323-326-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 CORSON ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911061606",
            "telephone_number": "323-326-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNAL",
        "first_name": "JESSE",
        "middle_name": "SAMSON-JACOB",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-21",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "84944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Stephen Bermudez, PH.D.
• Juanita Bermudez
• Ana Veronica Bernal
• Andrew Jose Bernal
• Armida Elena Bernal
• Julien Bernal
• Tania Bernal
• Melanie Bernard
• Catherine Bernarding, LCSW
• Michael Bernardo

• Marriage & Family Therapist in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.