Jennifer Nicole Smith

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT122639 Issued in CA

Practice address

3850 Crenshaw Blvd
Los Angeles, CA 90008-1821

Phone

(310) 631-8004

Fax

(310) 631-5875

NPI assigned

Apr 25, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/scharpca/r4/

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.

• Southern California Health & Rehabilitation Program

  • Community/Behavioral Health Agency
  • Los Angeles, CA
  • NPI 1083743082
  NPD (past)
• Southern California Health & Rehabilitation Program

  • Community/Behavioral Health Agency
  • Lynwood, CA
  • NPI 1467775221
  NPD (past)

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1780119065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900081821",
            "telephone_number": "310-631-8004",
            "fax_number": "310-631-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900081821",
            "telephone_number": "310-631-8004",
            "fax_number": "310-631-5875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3815 Marconi Ave",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958213867",
            "country_code": "US",
            "telephone_number": "916-584-7800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 S St",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "95811",
            "country_code": "US",
            "telephone_number": "916-548-7800",
            "fax_number": "916-914-2462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "AMFT122639",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT122639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jayla Janiece Smith, APCC
• Jeffrey Bernard Smith, M.D.
• Jelani Smith
• Jennifer Smith, L.AC
• Jennifer Ann Smith, MD
• Jerrold Smith
• Jimmie Lewis Smith Jr.
• Joann Smith
• Joann L Smith, MD
• Jonathan Smith, LMFT

• Marriage & Family Therapist in Los Angeles, CA
• Providers in Los Angeles, 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 Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.