Jean Therese Vergara Lao

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

ASW10971 Issued in CA

Practice address

679 S New Hampshire Ave
Los Angeles, CA 90005-1355

Phone

(626) 684-0496

NPI assigned

Apr 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1639732696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "679 S NEW HAMPSHIRE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900051355",
            "telephone_number": "626-684-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "679 S NEW HAMPSHIRE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900051355",
            "telephone_number": "626-684-0496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16410 Bloomfield Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Cerritos",
            "state": "CA",
            "postal_code": "907032144",
            "country_code": "US",
            "telephone_number": "562-760-4429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAO",
        "first_name": "JEAN",
        "middle_name": "THERESE VERGARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "109171",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW10971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin M Lantz, PT, DPT
• Kalena Lanuza, FNP-C, PMHNP-BC
• Ricardo Lanuza
• Misha Lanzat, D.P.M.
• Bryan Khanh Lao, MD
• Kateleen Sarah Lao
• Nicole Lao
• Tiffany Lao
• Yi Lao
• Rosalynn Laotheerachao, PHARM.D.

• Mental Health Counselor in Los Angeles, CA
• Providers in Los Angeles, 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 Jul 21, 2022; 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.