Jeremy Jensen, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

27984 Issued in CA

Practice address

6200 Wilshire Blvd Ste 1410
Los Angeles, CA 90048-5815

Phone

(925) 282-1778

NPI assigned

Jan 7, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Pacific Coast Psychiatric Associates Inc

  dba Lifestance Health

  • Clinical Psychologist
  • Scottsdale, AZ
  • NPI 1023125465

  CA

  Medicare reassignment

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

{
    "created_epoch": "1294358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1689978439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD STE 1410",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD STE 1410",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485815",
            "telephone_number": "925-282-1778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9410 Cameron St",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917305618",
            "country_code": "US",
            "telephone_number": "619-347-4743",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4141 Lei O Papa Rd Apt 49",
            "address_purpose": "LOCATION",
            "city": "Princeville",
            "state": "HI",
            "postal_code": "967225130",
            "country_code": "US",
            "telephone_number": "415-326-4051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "JEREMY",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-07",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "HI",
            "license": "2013",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "27984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bjorn Benjamin Jensen, M.D.
• Charlotte Jensen
• Dennis Michael Jensen, MD
• Ember Jensen, M.S.
• Ian Charles Jensen, LMFT
• Kaleb Russell Jensen
• Kathleen Jensen, LMFT
• Kirsten Elizabeth Jensen, M.D.
• Kristin Schwab Jensen, MD
• Lauren Alisha Jensen, PSYD

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.