Jessica Vechakul

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

123005 Issued in CA

Practice address

1500 Russell St
Berkeley, CA 94703-2020

Phone

(510) 545-3360

NPI assigned

Oct 31, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 17, 2024 through Feb 17, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Berkeley Holistic Therapy, a Marriage and Family Therapy Corporation

  • Marriage & Family Therapist
  • Berkeley, CA
  • NPI 1932799111
  NPD Authorized official
• Pacific Center for Human Growth

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Berkeley, CA
  • NPI 1043434095
  NPD (past)
• Pacific Center for Human Growth

  • Community/Behavioral Health Agency
  • Berkeley, CA
  • NPI 1275687717
  NPD (past)

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

{
    "created_epoch": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1841742350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 RUSSELL ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032020",
            "telephone_number": "510-545-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 RUSSELL ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032020",
            "telephone_number": "510-545-3360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "368 Fell St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941025144",
            "country_code": "US",
            "telephone_number": "415-861-0828",
            "fax_number": "415-861-0257",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2712 Telegraph Ave",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "94705",
            "country_code": "US",
            "telephone_number": "510-548-8283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VECHAKUL",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-31",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "123005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryna Vazmitsel, M.D.
• Cesar Ricardo Vazquez
• VC Enterprises, Inc
• Elizabeth Veale
• Lauren Rochelle Veasey, M.ED.
• Valerie Velarde
• Edmund Velasquez, DDS
• Felix Velasquez Jr.
• Keheolani Vele
• Kavitha Vellanki, FNP-C

• Marriage & Family Therapist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.

Verify at the official NPI Registry.