Active NPI
Jazmin Sepulveda
- Mental Health Counselor
- Los Angeles, CA
National Provider Identifier
1942553045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 92740
- Practice address
- 5849 Crocker St Unit L
Los Angeles, CA 90003-1311 - Phone
- (323) 234-4445
- Fax
- (323) 234-4477
- NPI assigned
- Oct 26, 2012
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 83012 | CA | |
| Case Manager/Care Coordinator | 171M00000X | |||
| Mental Health Counselor | 101YM0800X | 92740 | CA | Primary |
Addresses
Primary practice location
5849 Crocker St Unit L
Los Angeles, CA 90003-1311
Mailing address
5849 Crocker St Unit L
Los Angeles, CA 90003-1311
Phone (323) 234-4445
Other practice location 1
2101 E 101st St
Los Angeles, CA 90002-3116
Phone (323) 242-5000
Other practice location 2
108 W Victoria St
Gardena, CA 90248
Phone (310) 715-2020
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
| License | State | Type | Specialty |
|---|---|---|---|
| 83012 | CA | MD | Mental Health Counselor |
| 92740 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598486400000",
"number": "1942553045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5849 CROCKER ST UNIT L",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900031311",
"telephone_number": "323-234-4445",
"fax_number": "323-234-4477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5849 CROCKER ST UNIT L",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900031311",
"telephone_number": "323-234-4445",
"fax_number": "323-234-4477"
}
],
"practiceLocations": [
{
"address_1": "2101 E 101st St",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900023116",
"country_code": "US",
"telephone_number": "323-242-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "108 W Victoria St",
"address_purpose": "LOCATION",
"city": "Gardena",
"state": "CA",
"postal_code": "90248",
"country_code": "US",
"telephone_number": "310-715-2020",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SEPULVEDA",
"first_name": "JAZMIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-26",
"last_updated": "2020-08-27",
"certification_date": "2020-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "83012",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "92740",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.