Active NPI
Jared Carter Nelson
- Student in an Organized Health Care Education/Training Program
- Los Angeles, CA
National Provider Identifier
1972104552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 13019
- Practice address
- 9100 S Sepulveda Blvd Ste 105
Los Angeles, CA 90045-4849 - Phone
- (310) 644-3659
- NPI assigned
- Nov 2, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 13019 | CA | Primary |
Addresses
Primary practice location
9100 S Sepulveda Blvd Ste 105
Los Angeles, CA 90045-4849
Mailing address
4215 Don Tomaso Dr Apt 15
Los Angeles, CA 90008-5344
Phone (831) 809-6659
Other practice location 1
1334 Post Ave
Torrance, CA 90501-2620
Phone (310) 328-1460
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 |
|---|---|---|---|
| 13019 | CA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Health Services, Inc. | Past | Accepting new patients | |
| Behavioral Health Services, Inc. | 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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Torrance, CA
- NPI 1326322405
-
- Community/Behavioral Health Agency
- Los Angeles, CA
- NPI 1619422755
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785974400000",
"number": "1972104552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4215 DON TOMASO DR APT 15",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900085344",
"telephone_number": "831-809-6659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9100 S SEPULVEDA BLVD STE 105",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900454849",
"telephone_number": "310-644-3659"
}
],
"practiceLocations": [
{
"address_1": "1334 Post Ave",
"address_purpose": "LOCATION",
"city": "Torrance",
"state": "CA",
"postal_code": "905012620",
"country_code": "US",
"telephone_number": "310-328-1460",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NELSON",
"first_name": "JARED",
"middle_name": "CARTER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-02",
"last_updated": "2026-08-06",
"certification_date": "2026-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "13019",
"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 6, 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.