Individual provider Active NPI

Jocelyn Rae Clegg, MFT

  • Marriage & Family Therapist
  • Burbank, CA
National Provider Identifier
1811021595
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC38254 Issued in CA
Practice address
601 S Glenoaks Blvd
Suite 200
Burbank, CA 91502-1474
Phone
(818) 441-7800
Fax
(818) 441-0013
NPI assigned
Mar 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC38254 CA Primary

Addresses

Primary practice location

601 S Glenoaks Blvd
Suite 200
Burbank, CA 91502-1474

Mailing address

601 S Glenoaks Blvd
Suite 200
Burbank, CA 91502-1474
Phone (818) 441-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 29, 2024 through Jan 29, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC38254CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370217600000",
    "number": "1811021595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S GLENOAKS BLVD",
            "address_2": "SUITE 200",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021474",
            "telephone_number": "818-441-7800",
            "fax_number": "818-441-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S GLENOAKS BLVD",
            "address_2": "SUITE 200",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021474",
            "telephone_number": "818-441-7800",
            "fax_number": "818-441-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEGG",
        "first_name": "JOCELYN",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2013-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC38254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.