Jenna Quillen, M.S.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2866 Issued in OR

Practice address

66 Club Rd Ste 120
Eugene, OR 97401-2439

Phone

(541) 393-5983

Fax

(541) 393-5984

NPI assigned

Apr 18, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.jennaquillen@151848.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Western Psychological and Counseling Services LLC

  • Clinical Psychologist
  • Tacoma, WA
  • NPI 1912008178

  OR

  Medicare reassignment NPD
• Western Psychological and Counseling Services LLC

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1629345731
  NPD
• Neuvoa Counseling & Associates, LLC

  • Mental Health Counselor
  • Eugene, OR
  • NPI 1861195083
  NPD (past)
• Community Institute for Psychotherapy

  • Voluntary or Charitable Agency
  • San Rafael, CA
  • NPI 1760403794
  NPD (past)
• Community Institute for Psychotherapy

  • Community/Behavioral Health Agency
  • San Rafael, CA
  • NPI 1780995258
  NPD (past)

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

{
    "created_epoch": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1821432030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 CLUB RD STE 120",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 CLUB RD STE 120",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012439",
            "telephone_number": "541-393-5983",
            "fax_number": "541-393-5984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1330 Lincoln Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949012142",
            "country_code": "US",
            "telephone_number": "415-459-5999",
            "fax_number": "415-459-5602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUILLEN",
        "first_name": "JENNA",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-18",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2866",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "2866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Quest, LMT
• Ileana Quezada, CSFA
• Carly R Quick, QMHA
• Annie Claire Quigley, LMT
• Joseph Dana Quigley, LICENSED DENTURIST
• Quillin Family Medicine, LLC
• Elizabeth P Quillin, MD
• Cheryl Quinlan, MS, CCC-SLP
• Meghan Quinn, LMT
• Ruby Quintero

• Psychologist in Eugene, OR
• Providers in Eugene, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; 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.

Verify at the official NPI Registry.