Individual provider Active NPI

Erik Anderson, LMFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1104330406
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
111230 Issued in CA
Practice address
11949 Jefferson Blvd Ste 102
Los Angeles, CA 90230-6336
Phone
(323) 283-9207
NPI assigned
Nov 22, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2020

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 IMF82844 CA
Marriage & Family Therapist 106H00000X 111230 CA Primary

Addresses

Primary practice location

11949 Jefferson Blvd Ste 102
Los Angeles, CA 90230-6336

Mailing address

10866 Washington Blvd # 97
Culver City, CA 90232-3610
Phone (323) 283-9207

Other practice location 1

9740 W Pico Blvd
Los Angeles, CA 90035-4711
Phone (310) 945-0344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 18, 2024 through Mar 18, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
111230CAMDMarriage & Family Therapist
IMF82844CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1104330406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10866 WASHINGTON BLVD # 97",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902323610",
            "telephone_number": "323-283-9207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11949 JEFFERSON BLVD STE 102",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "902306336",
            "telephone_number": "323-283-9207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9740 W Pico Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900354711",
            "country_code": "US",
            "telephone_number": "310-945-0344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ERIK",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-22",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF82844",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "111230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.