Jessica Faith Achugbue
Individual provider Active NPI Marriage & Family Therapist · Long Beach, CA
NPI 1578030409 · NPPES record last updated Sep 28, 2021
Key facts
- NPI
- 1578030409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 127355 (CA)
- Practice address
- 1301 Pine Ave
Long Beach, CA 90813-3124 - Phone
- (562) 896-1786
- NPI assigned
- Oct 29, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-18-68977 | CA | MD | Behavior Technician |
| 127355 | CA | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-18-68977 | CA | |
| Marriage & Family Therapist | 106H00000X | 127355 | CA | Yes |
Addresses
Primary practice location
1301 Pine Ave
Long Beach, CA 90813-3124
Mailing address
1301 Pine Ave
Long Beach, CA 90813-3124
Phone (562) 896-1786
Other providers in Long Beach, CA
- Susana Guadalupe Aceves
- Lesly Yareli Acha
- Anjali L Acharya
- Nneoma Achikam
- Charles Acholonu
- Brian J. Acker
- Sadiq Akil Acklin
- Dwayne Acoba
- Reyno Butch Radoc Acoba
- Lucia Elena Acosta Loza
All providers in Long Beach, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.