Individual provider Active NPI

Jacquelyn Robinson, LMFT

  • Marriage & Family Therapist
  • San Bernardino, CA
National Provider Identifier
1841327715
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
104762 Issued in CA
Practice address
237 W Mill St
San Bernardino, CA 92408-1403
Phone
(909) 421-9479
NPI assigned
Feb 27, 2007
Last updated
Nov 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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 104762 CA Primary

Addresses

Primary practice location

237 W Mill St
San Bernardino, CA 92408-1403

Mailing address

923 Hyde CT
Costa Mesa, CA 92626-6924
Phone (714) 545-9756

Other practice location 1

4211 Avalon Blvd
Los Angeles, CA 90011-5622
Phone (323) 432-5185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, OR, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20241024000434 TN Practitioner - Marriage and Family Therapist 4486187820 Reassigns benefits to 2 organizations
I20260507002074 OR Practitioner - Marriage and Family Therapist 4486187820 Reassigns benefits to 1 organization
I20260507003414 CA Practitioner - Marriage and Family Therapist 4486187820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brightside Medical PCGroup PAC ID 6608262464, 274 clinicians
Talkspace Provider Network PAGroup PAC ID 5799136701, 249 clinicians

Practice addresses (Care Compare)

Knoxville, TN 37923
Phone (415) 360-3348

4248 Rachel Donelson Pass
Hermitage, TN 37076-2257
Phone (615) 473-8912

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Talkspace Provider Network PA CurrentSince Mar 8, 2025 Accepting new patients
Brightside Medical, P.C. CurrentSince Aug 1, 2024 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

2578 Broadway
Ste 607
New York, NY 10025
Phone (304) 308-3735

8913 Town and Country Cir
Knoxville, TN 37923
Phone (253) 861-0739

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1841327715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 HYDE CT",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926266924",
            "telephone_number": "714-545-9756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 W MILL ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924081403",
            "telephone_number": "909-421-9479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4211 Avalon Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900115622",
            "country_code": "US",
            "telephone_number": "323-432-5185",
            "fax_number": "323-432-5086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "JACQUELYN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "104762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.