Pamela Lynn Georgette, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC 49929 Issued in CA

Practice address

12725 Ventura Blvd Ste G
Studio City, CA 91604-2437

Phone

(818) 813-1621

NPI assigned

Jun 13, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1053571950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 OCEAN PARK BLVD # 107-3",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904053301",
            "telephone_number": "818-813-1621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12725 VENTURA BLVD STE G",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916042437",
            "telephone_number": "818-813-1621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGETTE",
        "first_name": "PAMELA",
        "middle_name": "LYNN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-13",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "49940",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 49929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "pamela@createachange.net",
            "affiliation": "N",
            "address_1": "12725 Ventura Blvd Ste G",
            "city": "Studio City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "916042437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Marriage & Family Therapist in Studio City, CA
• Providers in Studio City, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.