Active NPI
Jennifer Lynn Vermillion, LMFT 118030
- Mental Health Counselor
- Glendora, CA
National Provider Identifier
1568094068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 118030
- Practice address
- 1822 E Route 66 # 316
Glendora, CA 91740-3801 - Phone
- (626) 926-5709
- NPI assigned
- Feb 12, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 118030 | CA | Primary |
Addresses
Primary practice location
1822 E Route 66 # 316
Glendora, CA 91740-3801
Mailing address
1822 E Route 66 # 316
Glendora, CA 91740-3801
Phone (626) 926-5709
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 118030 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581465600000",
"number": "1568094068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1822 E ROUTE 66 # 316",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917403801",
"telephone_number": "626-926-5709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1822 E ROUTE 66 # 316",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917403801",
"telephone_number": "626-926-5709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERMILLION",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"credential": "LMFT 118030",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-12",
"last_updated": "2020-02-12",
"certification_date": "2020-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "118030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; 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.