Active NPI
Ian Charles Jensen, LMFT
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1841663069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 117013
- Practice address
- 2820 Glendale Blvd Ste 2
Los Angeles, CA 90039-2723 - Phone
- (323) 796-5550
- Fax
- (323) 843-9827
- NPI assigned
- Nov 10, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 117013 | CA | Primary |
Addresses
Primary practice location
2820 Glendale Blvd Ste 2
Los Angeles, CA 90039-2723
Mailing address
2820 Glendale Blvd Ste 2
Los Angeles, CA 90039-2723
Phone (323) 796-5550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01536011 | Other | CA | MEDI-CAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 12, 2024 through Feb 12, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 117013 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740700800000",
"number": "1841663069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2820 GLENDALE BLVD STE 2",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900392723",
"telephone_number": "323-796-5550",
"fax_number": "323-843-9827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2820 GLENDALE BLVD STE 2",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900392723",
"telephone_number": "323-796-5550",
"fax_number": "323-843-9827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "IAN",
"middle_name": "CHARLES",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-11-10",
"last_updated": "2025-02-28",
"certification_date": "2025-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "117013",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "01536011",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.