Active NPI
Jennifer Jo Dutton
- Mental Health Counselor
- Crescent City, CA
National Provider Identifier
1801429436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 89987
- Practice address
- 455 K St
Crescent City, CA 95531-4107 - Phone
- (707) 464-7224
- Fax
- (707) 465-4272
- NPI assigned
- Feb 21, 2020
- Last updated
- Feb 21, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 89987 | CA | Primary |
Addresses
Primary practice location
455 K St
Crescent City, CA 95531-4107
Mailing address
455 K St
Crescent City, CA 95531-4107
Phone (707) 464-7224
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
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
550 E Washington Blvd
Crescent City, CA 95531-8160
Phone (707) 465-6925
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 89987 | CA | MD | Pharmacist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Del Norte Community Health Center
- Federally Qualified Health Center (FQHC)
- Crescent City, CA
- NPI 1497840656
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582243200000",
"number": "1801429436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 K ST",
"city": "CRESCENT CITY",
"state": "CA",
"postal_code": "955314107",
"telephone_number": "707-464-7224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 K ST",
"city": "CRESCENT CITY",
"state": "CA",
"postal_code": "955314107",
"telephone_number": "707-464-7224",
"fax_number": "707-465-4272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUTTON",
"first_name": "JENNIFER",
"middle_name": "JO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-21",
"last_updated": "2020-02-21",
"certification_date": "2020-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "89987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crescent City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.