Daniel Scott Jimmerson, APCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

APCC9046 Issued in CA

Practice address

20331 Flanagan Road
Trabuco Canyon, CA 92679

Phone

(818) 582-8832

Fax

(818) 582-8836

NPI assigned

May 14, 2020

Sex

Male

Sole proprietor

No

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

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.

Opted out of Medicare

Yes, effective Feb 1, 2024 through Feb 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Teen Project, Inc.

  • Children's Substance Abuse Rehabilitation Facility
  • Trabuco Canyon, CA
  • NPI 1609345743
  NPD (past)

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1609498542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21951 RIMHURST DR UNIT J",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926305971",
            "telephone_number": "949-566-5039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20331 FLANAGAN ROAD",
            "city": "TRABUCO CANYON",
            "state": "CA",
            "postal_code": "92679",
            "telephone_number": "818-582-8832",
            "fax_number": "818-582-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMMERSON",
        "first_name": "DANIEL",
        "middle_name": "SCOTT",
        "credential": "APCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-14",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "APCC9046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alysia Israel
• Nicole Marie Ivery Davis, LVN
• Michael Justin James, D.C.
• Gina Marie Jamieson, RADT
• Tana Jimenez, PT
• Victoria Lynn Johnston
• Juste Ruzelyte DDS PC
• Kalapp Chiropractic
• Amanda Kasten
• Manika Kaushik

• Mental Health Counselor in Trabuco Canyon, CA
• Providers in Trabuco Canyon, 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 Jan 12, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.