Active NPI
Jennifer Kern
- Marriage & Family Therapist
- Oakland, CA
National Provider Identifier
1902574247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 166 Santa Clara Ave Ste 105
Oakland, CA 94610-1323 - Phone
- (510) 601-1929
- Fax
- (510) 601-1947
- NPI assigned
- Sep 1, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Marriage & Family Therapist | 106H00000X | Primary |
Addresses
Primary practice location
166 Santa Clara Ave Ste 105
Oakland, CA 94610-1323
Mailing address
PO Box 5324
Berkeley, CA 94705-0324
Other practice location 1
11175 San Pablo Ave
El Cerrito, CA 94530-2157
Phone (510) 559-5550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101YM0800X | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 17, 2025 through Apr 17, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663891200000",
"number": "1902574247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5324",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947050324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "166 SANTA CLARA AVE STE 105",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946101323",
"telephone_number": "510-601-1929",
"fax_number": "510-601-1947"
}
],
"practiceLocations": [
{
"address_1": "11175 San Pablo Ave",
"address_purpose": "LOCATION",
"city": "El Cerrito",
"state": "CA",
"postal_code": "945302157",
"country_code": "US",
"telephone_number": "510-559-5550",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KERN",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-01",
"last_updated": "2022-09-23",
"certification_date": "2022-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101YM0800X",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.