Individual provider Active NPI

Jessica Lynn Novoa, ASW

  • Mental Health Counselor
  • Santa Ana, CA
National Provider Identifier
1861773715
Registry record updated Nov 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
ASW36270 Issued in CA
Practice address
1666 N Main St
Suite 400
Santa Ana, CA 92701-7417
Phone
(714) 704-5900
Fax
(714) 978-3419
NPI assigned
Sep 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW36270 CA Primary

Addresses

Primary practice location

1666 N Main St
Suite 400
Santa Ana, CA 92701-7417

Mailing address

1666 N Main St
Suite 400
Santa Ana, CA 92701-7417
Phone (714) 704-5900

Other names 1

  • Miss Jessica Lynn Carpenter Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ASW36270CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416441600000",
    "number": "1861773715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1666 N MAIN ST",
            "address_2": "SUITE 400",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927017417",
            "telephone_number": "714-704-5900",
            "fax_number": "714-978-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1666 N MAIN ST",
            "address_2": "SUITE 400",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927017417",
            "telephone_number": "714-704-5900",
            "fax_number": "714-978-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOA",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "ASW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-06",
        "last_updated": "2014-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW36270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "CARPENTER",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.