Jenifer Chacon

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

108754 Issued in CA

Practice address

5150 E Pacific Coast Hwy Ste 100
Long Beach, CA 90804-3394

Phone

(562) 490-7600

NPI assigned

Oct 26, 2020

Last updated

Jun 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Allyson Wells MD Inc

  • Child & Adolescent Psychiatry Physician
  • Long Beach, CA
  • NPI 1770181257
  NPD
• Childnet Youth and Family Services Inc

  dba ChildNet Youth & Family Services Inc.

  • Community/Behavioral Health Agency
  • Long Beach, CA
  • NPI 1760519219
  NPD (past)

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1598365025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 E PACIFIC COAST HWY STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 E PACIFIC COAST HWY STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043394",
            "telephone_number": "562-490-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACON",
        "first_name": "JENIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "72236",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "108754",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "108754",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barry B Ceverha, M.D.
• Sandra K Ceverha, NP
• Mina M Cha, PHARM.D.
• Ariana Chacon
• Eduardo Chacon
• Maria Chacon
• Yesenia Chacon
• Caroline Chae, AMFT
• Jon Chaffee, M.D.
• Tracy Marie Chaffee, M.D.

• Mental Health Counselor in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Mental Health Counselor in California

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