Individual provider Active NPI

Suejin An, LMFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1003227653
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT103640 Issued in CA
Practice address
520 S la Fayette Park PL FL 3
Los Angeles, CA 90057-1607
Phone
(213) 252-2100
Fax
(213) 383-3146
NPI assigned
May 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT103640 CA Primary

Addresses

Primary practice location

520 S la Fayette Park PL FL 3
Los Angeles, CA 90057-1607

Mailing address

520 S Lafayette Park Place
3Rd Floor
Los Angeles, CA 90057
Phone (213) 252-2100

Other practice location 1

1310 Wilshire Blvd
Los Angeles, CA 90017-1705
Phone (213) 483-3000

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

LicenseStateTypeSpecialty
LMFT103640CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1003227653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S LAFAYETTE PARK PLACE",
            "address_2": "3RD FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90057",
            "telephone_number": "213-252-2100",
            "fax_number": "213-383-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S LA FAYETTE PARK PL FL 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900571607",
            "telephone_number": "213-252-2100",
            "fax_number": "213-383-3146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 Wilshire Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900171705",
            "country_code": "US",
            "telephone_number": "213-483-3000",
            "fax_number": "213-383-3146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AN",
        "first_name": "SUEJIN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-16",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT103640",
            "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 Dec 11, 2020; 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.