Active NPI
Jennifer Lee Sharples, PSY.D.
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1689600744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 19546
- Practice address
- 11835 W Olympic Blvd Ste 1265E
Los Angeles, CA 90064-5814 - Phone
- (310) 273-4843
- Fax
- (310) 273-5056
- NPI assigned
- Jun 23, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 19546 | CA | Primary |
Addresses
Primary practice location
11835 W Olympic Blvd Ste 1265E
Los Angeles, CA 90064-5814
Mailing address
11835 W Olympic Blvd Ste 1265E
Los Angeles, CA 90064-5814
Phone (310) 273-4843
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 19546 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Current | Accepting new patients | |
| Brian Wu MD PHD Inc | Current | Accepting new patients |
Locations
16890 Green Tree Blvd
Victorville, CA 92395
Phone (310) 273-4843
Interoperability endpoints
- jennifersharples@tdh.allscriptsdirect.net
Organizations & group practices 2
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.
-
- Psychiatry Physician
- San Gabriel, CA
- NPI 1528639481
-
- Family Medicine Physician
- Lewisville, TX
- NPI 1245403567
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518048000000",
"number": "1689600744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11835 W OLYMPIC BLVD STE 1265E",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900645814",
"telephone_number": "310-273-4843",
"fax_number": "310-273-5056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11835 W OLYMPIC BLVD STE 1265E",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900645814",
"telephone_number": "310-273-4843",
"fax_number": "310-273-5056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHARPLES",
"first_name": "JENNIFER",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-23",
"last_updated": "2018-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 19546",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.