Active NPI
Risa Sherwood Gordon, MFT
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1104029891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 15299
- Practice address
- 3760 Motor Ave
Suite 311
Los Angeles, CA 90034-6404 - Phone
- (310) 837-6368
- Fax
- (310) 837-3486
- NPI assigned
- Jun 8, 2007
- Sex
- Female
- 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 | 15299 | CA | Primary |
Addresses
Primary practice location
3760 Motor Ave
Suite 311
Los Angeles, CA 90034-6404
Mailing address
3641 Tilden Ave
Los Angeles, CA 90034-6909
Phone (310) 837-6368
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 16, 2024 through Jan 16, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104029891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3641 TILDEN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900346909",
"telephone_number": "310-837-6368",
"fax_number": "310-837-3486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3760 MOTOR AVE",
"address_2": "SUITE 311",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900346404",
"telephone_number": "310-837-6368",
"fax_number": "310-837-3486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "RISA",
"middle_name": "SHERWOOD",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "15299",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.