Jennifer Lynn Lively

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

704 W 8TH St
San Pedro, CA 90731-3017

Phone

(310) 832-7545

Fax

(310) 833-8530

NPI assigned

Jul 28, 2010

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• The San Pedro Clinic

  • Point of Service
  • San Pedro, CA
  • NPI 1467766691
  NPD (past)

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282262400000",
    "number": "1558675934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 W 8TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313017",
            "telephone_number": "310-832-7545",
            "fax_number": "310-833-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 W 8TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313017",
            "telephone_number": "310-832-7545",
            "fax_number": "310-833-8530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVELY",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-28",
        "last_updated": "2010-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Humphreys MD MPH, Physician, Inc
• Erin Marie Lisko, PA-C
• Little Company of Mary - San Pedro (Little Company of Mary Pavilion San - Pedro)
• Little Sisters of the Poor
• Michelle Litton, M.S., CCC-SLP
• Knef V Lizaso, M.D.
• Alexa Saray Llamas, RN
• Gladys Llamas
• James T London, MD
• Dylan James Long, RAD-T

• Counselor in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; 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.