Lisa Jellison, MA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC 46430 Issued in CA

Practice address

3191 Churn Creek Rd
Redding, CA 96002-2123

Phone

(530) 224-7160

NPI assigned

Jan 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Remi Vista Inc.

  • Community/Behavioral Health Agency
  • Redding, CA
  • NPI 1194778803
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268092800000",
    "number": "1700935657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 991464",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960991464",
            "telephone_number": "530-605-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3191 CHURN CREEK RD",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960022123",
            "telephone_number": "530-224-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JELLISON",
        "first_name": "LISA",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2010-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 46430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Janiszewski, MSOP CPO
• Daniel Fred Jaramillo II, P.A.
• Meagan Ray Jarding, LCSW
• Mary Jasey
• Desiree Ann Jayne, LCSW
• Samantha Lynn Jenkins
• Eric J Jenkinson, MD
• Julia Jennex
• Brandon Jennings, FNP-C
• Raven Anne Jennings, FNP

• Marriage & Family Therapist in Redding, CA
• Providers in Redding, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.