Active NPI
Eitan Kadosh, LMFT
- Marriage & Family Therapist
- Marina del Rey, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 101254
- Practice address
- 13160 Mindanao Way Ste 213
Marina del Rey, CA 90292-6358 - Phone
- (925) 282-1778
- NPI assigned
- Jul 12, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 101254 | CA | Primary |
Addresses
Primary practice location
13160 Mindanao Way Ste 213
Marina del Rey, CA 90292-6358
Mailing address
13160 Mindanao Way Ste 213
Marina del Rey, CA 90292-6358
Other practice location 1
1450 10th St Ste 404
Santa Monica, CA 90401-2831
Phone (925) 282-1778
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
13160 Mindanao Way
Suite 213
Marina del Rey, CA 90292-6358
Phone (925) 282-1778
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101254 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Coast Psychiatric Associates Inc | Current | Accepting new patients |
Locations
6200 Wilshire Blvd
Ste 1410
Los Angeles, CA 90048
Phone (323) 403-0474
13160 Mindanao Way
Ste 213
Marina del Rey, CA 90292
490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944
1450 10th St
Ste 404
Santa Monica, CA 90401
Phone (310) 451-8144
Interoperability endpoints
- lifestancehealth.eitankadosh@148377.advancedmd-direct.com
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": "1499817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724976000000",
"number": "1013439884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13160 MINDANAO WAY STE 213",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902926358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13160 MINDANAO WAY STE 213",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902926358",
"telephone_number": "925-282-1778"
}
],
"practiceLocations": [
{
"address_1": "1450 10th St Ste 404",
"address_purpose": "LOCATION",
"city": "Santa Monica",
"state": "CA",
"postal_code": "904012831",
"country_code": "US",
"telephone_number": "925-282-1778",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KADOSH",
"first_name": "EITAN",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-07-12",
"last_updated": "2024-08-30",
"certification_date": "2024-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "101254",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marina del Rey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.