Active NPI
Jennifer A Nevitt, PSYD
- Clinical Psychologist
- Pomona, CA
National Provider Identifier
1790267292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY15338
- Practice address
- 2030 N Garey Ave
Pomona, CA 91767-2722 - Phone
- (909) 593-2585
- NPI assigned
- Aug 30, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY15338 | CA | |
| Clinical Psychologist | 103TC0700X | PSY15338 | CA | Primary |
Addresses
Primary practice location
2030 N Garey Ave
Pomona, CA 91767-2722
Mailing address
731 Esther LN
Redwood City, CA 94062-2819
Phone (650) 533-7602
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY15338 | CA | MD | Psychologist |
| 15338 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540339200000",
"number": "1790267292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "731 ESTHER LN",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940622819",
"telephone_number": "650-533-7602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2030 N GAREY AVE",
"city": "POMONA",
"state": "CA",
"postal_code": "917672722",
"telephone_number": "909-593-2585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEVITT",
"first_name": "JENNIFER",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-30",
"last_updated": "2018-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY15338",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY15338",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.