Jacqueline Ann Niedzwiecki, M.S., LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

96393 Issued in CA

Practice address

14658 Oxnard St
Van Nuys, CA 91411-3119

Phone

(818) 785-0703

Fax

(818) 785-0145

NPI assigned

Jan 8, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• San Fernando Valley Community Mental Health Center - FSP

  • Community/Behavioral Health Agency
  • Van Nuys, CA
  • NPI 1780838235
  NPD (past)

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

{
    "created_epoch": "1357603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1881931020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S SUNSET CANYON DR",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915011102",
            "telephone_number": "818-970-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14658 OXNARD ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914113119",
            "telephone_number": "818-785-0703",
            "fax_number": "818-785-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDZWIECKI",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "M.S., LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-08",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "96393",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nicholas J Bevilacqua D P M Inc
• Nicholas George Nickols, M.D., PH.D.
• Mihai Nicolae
• Xyntier Patrick Niega, LMFT
• Sapphire Nieto
• Daniel Nieves
• Monica Nieves
• Nightfall Healthcare, Inc.

• Marriage & Family Therapist in Van Nuys, CA
• Providers in Van Nuys, 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 Aug 30, 2021; 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.