Kelly Jyunko Dickson, MS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

8616 La Tijera Blvd Ste 200
Los Angeles, CA 90045-3945

Phone

(310) 337-1550

NPI assigned

Oct 1, 2010

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1285891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1780993238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8616 LA TIJERA BLVD STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453945",
            "telephone_number": "310-337-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8616 LA TIJERA BLVD STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453945",
            "telephone_number": "310-337-1550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14411 Vanowen St",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914054038",
            "country_code": "US",
            "telephone_number": "818-989-7475 x311",
            "fax_number": "818-901-0781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "KELLY",
        "middle_name": "JYUNKO",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-01",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aileen Marie Dickinson, D.O.
• Amber Dickinson
• Carrie Dickman
• David Alec Dickson, MD, PHD
• June Dickson
• Leonard Dickson
• Susan Dickson
• Tia Lynnel Dickson
• Tomorrow Dickson
• Analiese Marie Diconti-Gibbs, M.D.

• Professional Counselor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; 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.