Active NPI
Jennifer Anne Welch
- Mental Health Counselor
- Davis, CA
National Provider Identifier
1770600470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 83164
- Practice address
- 102 E St
Davis, CA 95616-4633 - Phone
- (530) 564-2306
- Fax
- (530) 564-2306
- NPI assigned
- Mar 26, 2007
- Last updated
- Mar 1, 2015
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 83164 | CA | Primary |
Addresses
Primary practice location
102 E St
Davis, CA 95616-4633
Mailing address
102 E St
Davis, CA 95616-4633
Phone (530) 564-2306
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 94-262-3205 | Other | CA | EMPLOYER IDENTIFICATION |
Medicare participation
Medicare enrollment files- 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83164 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425168000000",
"number": "1770600470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 E ST",
"city": "DAVIS",
"state": "CA",
"postal_code": "956164633",
"telephone_number": "530-564-2306",
"fax_number": "530-564-2306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 E ST",
"city": "DAVIS",
"state": "CA",
"postal_code": "956164633",
"telephone_number": "530-564-2306",
"fax_number": "530-564-2306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELCH",
"first_name": "JENNIFER",
"middle_name": "ANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2015-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "83164",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPLOYER IDENTIFICATION",
"identifier": "94-262-3205",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Davis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2015; 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.