Active NPI
Lisa R Jackson-Zeno
- Contractor
- Los Angeles, CA
National Provider Identifier
1992367296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 800 W 6TH St Ste 1505
Los Angeles, CA 90017-2742 - Phone
- (213) 760-4630
- NPI assigned
- Jul 8, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Contractor | 171W00000X | Primary |
Addresses
Primary practice location
800 W 6TH St Ste 1505
Los Angeles, CA 90017-2742
Mailing address
1343 W 90TH St
Los Angeles, CA 90044-2031
Phone (310) 686-6092
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Broad Horizons Marriage and Family Counseling, Prof. Corp. | Current | Accepting new patients |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Agoura Hills, CA
- NPI 1144461690
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642118400000",
"number": "1992367296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1343 W 90TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900442031",
"telephone_number": "310-686-6092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 W 6TH ST STE 1505",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900172742",
"telephone_number": "213-760-4630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON-ZENO",
"first_name": "LISA",
"middle_name": "R",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-08",
"last_updated": "2022-01-14",
"certification_date": "2022-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"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 Jan 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.