JESSICA KIESENDAHL MFT
NPI 1790817682
Marriage & Family Therapist in San Dimas, CA

Q: What is Jessica Kiesendahl's NPI number?

The NPI number for Jessica Kiesendahl is 1790817682. It was assigned to this individual provider in the NPPES registry on March 9, 2007. The provider is also known as Miss Jessica Williams B.A., Mft.

Q: What is Jessica Kiesendahl's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Active since March 09, 2007PECOS Enrolled

762 W CYPRESS AVE, SAN DIMAS, CA 91773(909) 599-1227(909) 599-4157 Get Directions Write a Review

NPPES record last updated: December 9, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 9, 2024, Dec 6, 2024, Sep 14, 2018 (3 updates tracked since 2018).

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About Jessica Kiesendahl Mft NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSICA KIESENDAHL MFT (NPI 1790817682) is an individual marriage & family therapist in San Dimas, California, licensed in California (80216) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790817682

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameJESSICA KIESENDAHLCredential: MFT

Location Address762 W CYPRESS AVESan Dimas, CA 91773-3505

Mailing Address762 W Cypress AveSan Dimas, CA 91773-3505 · (909) 599-1227 · Fax (909) 599-4157

Phone(909) 599-1227

Fax(909) 599-4157

Sole ProprietorNo

Enumeration DateMarch 9, 2007

Last NPPES UpdateDecember 9, 20243 updates tracked since enumeration

NPPES CertifiedDecember 9, 2024

✔ NPI 1790817682 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · 80216

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

762 W CYPRESS AVE, San Dimas, CA 91773

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Other Names 1

Former Name (1)Miss Jessica Williams B.a., Mft

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jessica Kiesendahl Mft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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