Individual provider Active NPI

Judith Lyn Jensen, PSY.D

  • Clinical Psychologist
  • Fullerton, CA
National Provider Identifier
1679562508
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY6450 Issued in CA
Practice address
285 Imperial Hwy
Suite 105
Fullerton, CA 92835-1048
Phone
(714) 578-9330
Fax
(714) 578-9339
NPI assigned
Oct 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY6450 CA Primary

Addresses

Primary practice location

285 Imperial Hwy
Suite 105
Fullerton, CA 92835-1048

Mailing address

285 Imperial Hwy
Suite 105
Fullerton, CA 92835-1048
Phone (714) 578-9330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071227000406 CA Practitioner - Clinical Psychologist 5395700843 Practice locations: Fullerton, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

285 E Imperial Hwy
Suite 105
Fullerton, CA 92835-1048

285 Imperial Hwy 105
Fullerton, CA 92835-1048
Phone (714) 578-9330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY6450CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Joe F. Chiu, MD, a Professional Corp Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1679562508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 IMPERIAL HWY",
            "address_2": "SUITE 105",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351048",
            "telephone_number": "714-578-9330",
            "fax_number": "714-578-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 IMPERIAL HWY",
            "address_2": "SUITE 105",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351048",
            "telephone_number": "714-578-9330",
            "fax_number": "714-578-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "JUDITH",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY6450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.