Active NPI
Jennifer F. Taylor, PH. D.
- Counseling Psychologist
- Arcata, CA
National Provider Identifier
1790779338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- PSY18047
- Practice address
- 1433 11TH St # F
Arcata, CA 95521-5712 - Phone
- (707) 826-9601
- NPI assigned
- Sep 9, 2005
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PSY18047 | CA | Primary |
Addresses
Primary practice location
1433 11TH St # F
Arcata, CA 95521-5712
Mailing address
799 H St # 239
Arcata, CA 95521-6240
Phone (707) 826-9601
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OPL180470 | Other | CA | BLUE SHIELD PIN |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040309000658 | CA | Practitioner - Clinical Psychologist | 4880597061 | Practice locations: Arcata, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1433 11TH St
F
Arcata, CA 95521-5712
Phone (707) 826-9601
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18047 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682380800000",
"number": "1790779338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "799 H ST # 239",
"city": "ARCATA",
"state": "CA",
"postal_code": "955216240",
"telephone_number": "707-826-9601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1433 11TH ST # F",
"city": "ARCATA",
"state": "CA",
"postal_code": "955215712",
"telephone_number": "707-826-9601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "JENNIFER",
"middle_name": "F.",
"name_prefix": "Dr.",
"credential": "PH. D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-09-09",
"last_updated": "2023-04-25",
"certification_date": "2023-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "PSY18047",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD PIN",
"identifier": "OPL180470",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Arcata, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.