Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Autumn Jefferson

Individual provider Clinical Psychologist · NPI 1659409654

Autumn Jefferson is a Clinical Psychologist in Los Angeles, California. Qualified in 2014, 12 years ago. Practices with Executive Mental Health, Inc, a 47-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
12
Licensed in
CA
In the registry since
2007
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Practice location Address checks out

4211 Avalon Blvd
Los Angeles, CA 90011-5622
Phone: (323) 432-5185
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY33479 (CA)

Record details

NPI number1659409654
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 1, 2007
Last updated in NPPESOctober 16, 2024
Certification dateOctober 16, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Executive Mental Health, Inc — 47 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Los Angeles