Individual provider Active NPI

Jessica April Lara, PSYD

  • Psychologist
  • Arcata, CA
National Provider Identifier
1992174965
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
30688 Issued in CA
Practice address
801 Crescent Way Ste 4
Arcata, CA 95521-6781
Phone
(707) 677-8200
Fax
(707) 826-8638
NPI assigned
Sep 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 30688 CA Primary

Addresses

Primary practice location

801 Crescent Way Ste 4
Arcata, CA 95521-6781

Mailing address

801 Crescent Way Ste 4
Arcata, CA 95521-6781
Phone (707) 677-8200

Other names 1

  • Jessica April Fouks Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
New Growth Psychology Inc Psychologist CurrentSince May 1, 2024 Accepting new patients

Locations

801 Crescent Way
Ste 4
Arcata, CA 95521
Phone (707) 677-8200

350 E St
Ste 305
Eureka, CA 95501
Phone (707) 677-8200

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1992174965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 CRESCENT WAY STE 4",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955216781",
            "telephone_number": "707-677-8200",
            "fax_number": "707-826-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 CRESCENT WAY STE 4",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955216781",
            "telephone_number": "707-677-8200",
            "fax_number": "707-826-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARA",
        "first_name": "JESSICA",
        "middle_name": "APRIL",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-21",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "30688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "FOUKS",
            "middle_name": "APRIL",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Arcata, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; 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.