Jenna I Metellus, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

30486 Issued in CA

Practice address

6320 Canoga Ave
Woodland Hills, CA 91367-2526

Phone

(818) 227-5000

NPI assigned

Aug 24, 2012

Last updated

Apr 21, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Ms. Jenna I Washington Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Affinity Health Psychological Corporation

  • Community/Behavioral Health Agency
  • Woodland Hills, CA
  • NPI 1104422997
  NPD Authorized official
• Affinityx, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Woodland Hills, CA
  • NPI 1336769272
  NPD Authorized official

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

{
    "created_epoch": "1345766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1891043865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57064",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914132064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 CANOGA AVE",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913672526",
            "telephone_number": "818-227-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METELLUS",
        "first_name": "JENNA",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-24",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "30486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "WASHINGTON",
            "middle_name": "I",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David P. Mesna, MD
• Nicole Mesriani
• Anaiya Q Messa-Street
• Navid Messian, LMFT
• Bernitha Metayer
• Lisa Mey
• Evie Ball Meyer, MFT
• Jacqueline J Meyer
• Kyle Meyerowitz, CCC-SLP
• Aarely Meza-Velarde

• Clinical Psychologist in Woodland Hills, CA
• Providers in Woodland Hills, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; 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.