Individual provider Active NPI

Julie M Vezina, LMFT

  • Marriage & Family Therapist
  • Mission Hills, CA
National Provider Identifier
1053814004
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
114601 Issued in CA
Practice address
15455 San Fernando Mission Blvd Ste 300
Mission Hills, CA 91345-1353
Phone
(747) 245-5049
NPI assigned
Mar 16, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 101720 CA
Marriage & Family Therapist 106H00000X 114601 CA Primary

Addresses

Primary practice location

15455 San Fernando Mission Blvd Ste 300
Mission Hills, CA 91345-1353

Mailing address

15455 San Fernando Mission Blvd Ste 300
Mission Hills, CA 91345-1353
Phone (747) 245-5049

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
114601CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1053814004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15455 SAN FERNANDO MISSION BLVD STE 300",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451353",
            "telephone_number": "747-245-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15455 SAN FERNANDO MISSION BLVD STE 300",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451353",
            "telephone_number": "747-245-5049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEZINA",
        "first_name": "JULIE",
        "middle_name": "M",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-16",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "101720",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "114601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; 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.