Individual provider Active NPI

Jean Thomas

  • Clinical Psychologist
  • Pasadena, CA
National Provider Identifier
1649671314
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY32701 Issued in CA
Practice address
95 N Marengo Ave Ste 200
Pasadena, CA 91101-1746
Phone
(626) 585-8075
NPI assigned
Sep 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Counselor 225C00000X
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X PSY32701 CA Primary

Addresses

Primary practice location

95 N Marengo Ave Ste 200
Pasadena, CA 91101-1746

Mailing address

66 Hurlbut St
Pasadena, CA 91105-4025
Phone (626) 441-4221

Other practice location 1

66 Hurlbut St
Pasadena, CA 91105-4025
Phone (626) 441-4221

Other practice location 2

3075 Adeline St
ste 120
Berkeley, CA 94703-2576
Phone (510) 848-1112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY32701CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Through the Looking Glass PastSince Feb 4, 2012 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1649671314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 HURLBUT ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911054025",
            "telephone_number": "626-441-4221",
            "fax_number": "626-441-6479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 N MARENGO AVE STE 200",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011746",
            "telephone_number": "626-585-8075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "66 Hurlbut St",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911054025",
            "country_code": "US",
            "telephone_number": "626-441-4221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3075 Adeline St",
            "address_2": "ste 120",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947032576",
            "country_code": "US",
            "telephone_number": "510-848-1112",
            "fax_number": "510-848-4445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY32701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.