Individual provider Active NPI

Jennifer Dee Stinson, PH.D.

  • Clinical Psychologist
  • Pasadena, CA
National Provider Identifier
1770628950
Registry record updated Jun 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY20997 Issued in CA
Practice address
2550 E Foothill Blvd FL 2
Pasadena, CA 91107-3406
Phone
(626) 744-5230
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY20997 CA Primary

Addresses

Primary practice location

2550 E Foothill Blvd FL 2
Pasadena, CA 91107-3406

Mailing address

2550 E Foothill Blvd FL 2
Pasadena, CA 91107-3406
Phone (626) 744-5230

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
I20150828001370 CA Practitioner - Clinical Psychologist 8628384120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Soultenders IncGroup PAC ID 6507170453, 113 clinicians

Practice addresses (Care Compare)

41 E Foothill Blvd
Suite 102
Arcadia, CA 91006-2361
Phone (626) 701-4249

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY20997CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Soultenders, Inc. Clinical CurrentSince Jul 16, 2015 Accepting new patients
Soultenders Psychological Services, Inc. CurrentSince Jul 2, 2026 Accepting new patients

Locations

41 E Foothill Blvd
Ste 102
Arcadia, CA 91006
Phone (626) 701-4249

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1770628950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 E FOOTHILL BLVD FL 2",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073406",
            "telephone_number": "626-744-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 E FOOTHILL BLVD FL 2",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073406",
            "telephone_number": "626-744-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINSON",
        "first_name": "JENNIFER",
        "middle_name": "DEE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.