Jenna Leigh Axelrod, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

071010512 Issued in IL

Practice address

17315 Studebaker Rd Ste 105
Cerritos, CA 90703-2565

Phone

(562) 999-4707

Fax

(877) 741-9754

NPI assigned

Apr 22, 2021

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

Enrolled in CA

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

R Franklin University of Med & Sci/Chicago Medical School, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

W Joshua Johnson Psychologist IncGroup PAC ID 5395008494, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• W Joshua Johnson Psychologist Inc

  • Clinical Psychologist
  • Cerritos, CA
  • NPI 1992209654

  Clinical Neuropsychologist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1861074502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17315 STUDEBAKER RD STE 105",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032565",
            "telephone_number": "562-999-4707",
            "fax_number": "877-741-9754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17315 STUDEBAKER RD STE 105",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032565",
            "telephone_number": "562-999-4707",
            "fax_number": "877-741-9754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AXELROD",
        "first_name": "JENNA",
        "middle_name": "LEIGH",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071010512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miriam Avila
• Virginia Aviles-Corona
• Monic Zabrina Avina
• Yolanda Avitia
• Jolia S Awadallah
• Mallory Ruth Axelrod, LCSW
• Jay Azling, DDS
• Francisco Licopit Badar III, MD
• Badii Lee Dental Corporation, Inc (Smile Wide)
• Linda Badillo

• Clinical Neuropsychologist in Cerritos, CA
• Providers in Cerritos, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.