Active NPI
Jenna Palacios
- Psychologist
- Long Beach, CA
National Provider Identifier
1699649533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4299
- Practice address
- 3701 Long Beach Blvd Ste 330
Long Beach, CA 90807-3346 - Phone
- (562) 285-7513
- NPI assigned
- Oct 2, 2025
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 4299 | CA | |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 4299 | CA | |
| School Psychologist | 103TS0200X | CA | ||
| Psychologist | 103T00000X | 4299 | CA | Primary |
Addresses
Primary practice location
3701 Long Beach Blvd Ste 330
Long Beach, CA 90807-3346
Mailing address
2436 E 4TH St # 191
Long Beach, CA 90814-1156
Phone (562) 285-7513
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4299 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759363200000",
"number": "1699649533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2436 E 4TH ST # 191",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908141156",
"telephone_number": "562-285-7513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3701 LONG BEACH BLVD STE 330",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908073346",
"telephone_number": "562-285-7513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALACIOS",
"first_name": "JENNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-10-02",
"last_updated": "2025-10-02",
"certification_date": "2025-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "CA",
"license": "4299",
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "CA",
"license": "4299",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "4299",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.