Active NPI
Jessica P Lan
- Marriage & Family Therapist
- Commerce, CA
National Provider Identifier
1669015194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 114853
- Practice address
- 5400 E Olympic Blvd FL 1
Commerce, CA 90022-5147 - Phone
- (323) 869-9255
- NPI assigned
- Oct 28, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 114853 | CA | Primary |
Addresses
Primary practice location
5400 E Olympic Blvd FL 1
Commerce, CA 90022-5147
Mailing address
815 Colorado Blvd Ste 300
Los Angeles, CA 90041-1744
Phone (323) 543-2800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 6, 2024 through Nov 6, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622160000000",
"number": "1669015194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 COLORADO BLVD STE 300",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900411744",
"telephone_number": "323-543-2800",
"fax_number": "323-978-1263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5400 E OLYMPIC BLVD FL 1",
"city": "COMMERCE",
"state": "CA",
"postal_code": "900225147",
"telephone_number": "323-869-9255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAN",
"first_name": "JESSICA",
"middle_name": "P",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-28",
"last_updated": "2021-05-28",
"certification_date": "2021-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "114853",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Commerce, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.