Active NPI
Dawn Alicia Pesso, MFT
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1023249372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC45142
- Practice address
- 10436 Santa Monica Blvd.
Ste. #3030
Los Angeles, CA 90025 - Phone
- (310) 470-9630
- NPI assigned
- Aug 5, 2009
- Reactivated
- Jan 26, 2017
- Sex
- Female
- Sole proprietor
- No
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 | MFC45142 | CA | Primary |
Addresses
Primary practice location
10436 Santa Monica Blvd.
Ste. #3030
Los Angeles, CA 90025
Mailing address
9451 Corbin Ave.
Ste. #100
Northridge, CA 91324
Phone (800) 321-2843
Other names 1
- Dawn Alicia Olufson
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
| License | State | Type | Specialty |
|---|---|---|---|
| MFC45142 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holman Family Counseling Inc | Past | Accepting new patients | |
| Comprehensive Behavioral Care California | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Psychiatry Physician
- Northridge, CA
- NPI 1427537539
-
- Psychiatry Physician
- Northridge, CA
- NPI 1831678085
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485388800000",
"number": "1023249372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9451 CORBIN AVE.",
"address_2": "STE. #100",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "91324",
"telephone_number": "800-321-2843",
"fax_number": "818-704-4252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10436 SANTA MONICA BLVD.",
"address_2": "STE. #3030",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90025",
"telephone_number": "310-470-9630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PESSO",
"first_name": "DAWN",
"middle_name": "ALICIA",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-05",
"last_updated": "2017-01-26",
"deactivation_date": "2012-06-13",
"reactivation_date": "2017-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC45142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DAWN",
"last_name": "OLUFSON",
"middle_name": "ALICIA",
"code": "5",
"type": "Other Name"
}
]
}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 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.