Individual provider Active NPI

Anis Jaouad

  • Psychologist
  • Glenolden, PA
National Provider Identifier
1902730666
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
234 Spruce St
Glenolden, PA 19036-1019
Phone
(610) 390-3214
NPI assigned
Jun 9, 2026
Last updated
Jun 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

234 Spruce St
Glenolden, PA 19036-1019

Mailing address

234 Spruce St
Glenolden, PA 19036-1019

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

NPI Registry JSON

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

{
    "created_epoch": "1780963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1902730666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 SPRUCE ST",
            "city": "GLENOLDEN",
            "state": "PA",
            "postal_code": "190361019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 SPRUCE ST",
            "city": "GLENOLDEN",
            "state": "PA",
            "postal_code": "190361019",
            "telephone_number": "610-390-3214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAOUAD",
        "first_name": "ANIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-09",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenolden, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; 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.