Individual provider Active NPI

Jennifer Phuong Nguyen, LMFT 152143

  • Marriage & Family Therapist
  • Morgan Hill, CA
National Provider Identifier
1952766230
Registry record updated Dec 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
152143 Issued in CA
Practice address
19050 Malaguerra Ave
Morgan Hill, CA 95037-9032
Phone
(408) 961-4636
NPI assigned
Dec 30, 2015
Last updated
Dec 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 152143 CA Primary

Addresses

Primary practice location

19050 Malaguerra Ave
Morgan Hill, CA 95037-9032

Mailing address

19050 Malaguerra Ave
Morgan Hill, CA 95037-9032
Phone (408) 961-4636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260611001576 CA Practitioner - Marriage and Family Therapist 4587136478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Dallas, TX 75373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
152143CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Learning and Autism Support Services, Inc. Behavior Analyst Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734998400000",
    "number": "1952766230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19050 MALAGUERRA AVE",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950379032",
            "telephone_number": "408-961-4636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19050 MALAGUERRA AVE",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950379032",
            "telephone_number": "408-961-4636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JENNIFER",
        "middle_name": "PHUONG",
        "name_prefix": "Miss",
        "credential": "LMFT 152143",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-30",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "152143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgan Hill, CA

Sources for this page

Verify at the official NPI Registry.