Individual provider Active NPI

Jennifer Purificacion, LMFT

  • Marriage & Family Therapist
  • West Covina, CA
National Provider Identifier
1700465408
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
155577 Issued in CA
Practice address
2155 E Garvey Ave N Ste B17
West Covina, CA 91791-1545
Phone
(626) 489-9144
NPI assigned
Apr 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 155577 CA Primary

Addresses

Primary practice location

2155 E Garvey Ave N Ste B17
West Covina, CA 91791-1545

Mailing address

2155 E Garvey Ave N Ste B17
West Covina, CA 91791-1545
Phone (626) 489-9144

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
I20250714003739 CA Practitioner - Marriage and Family Therapist 5890200398 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
155577CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Through the Sea Marriage and Family Counseling Inc Marriage & Family Therapist CurrentSince Jun 24, 2025 Accepting new patients
Descanso Home Health Services PastSince Jun 23, 2025 Accepting new patients

Locations

2155 E Garvey Ave N
Ste B17
West Covina, CA 91791
Phone (626) 489-9114

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.

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1700465408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 E GARVEY AVE N STE B17",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911545",
            "telephone_number": "626-489-9144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 E GARVEY AVE N STE B17",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911545",
            "telephone_number": "626-489-9144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURIFICACION",
        "first_name": "JENNIFER",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "155577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.