Active NPI
Jaime Emilio Cruz, APCC
- Mental Health Counselor
- Northridge, CA
National Provider Identifier
1972350239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 14096
- Practice address
- 9029 Reseda Blvd
Northridge, CA 91324-3932 - Phone
- (626) 268-0069
- NPI assigned
- May 3, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 14096 | CA | Primary |
Addresses
Primary practice location
9029 Reseda Blvd
Northridge, CA 91324-3932
Mailing address
13017 Glamis St
Pacoima, CA 91331-3237
Phone (818) 233-6865
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 |
|---|---|---|---|
| 14096 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714694400000",
"number": "1972350239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13017 GLAMIS ST",
"city": "PACOIMA",
"state": "CA",
"postal_code": "913313237",
"telephone_number": "818-233-6865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9029 RESEDA BLVD",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913243932",
"telephone_number": "626-268-0069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "JAIME",
"middle_name": "EMILIO",
"credential": "APCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-05-03",
"last_updated": "2024-05-03",
"certification_date": "2024-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "14096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northridge, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.