Jodi Blackley, L.M.F.T.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC41465 Issued in CA

Practice address

2555 E Chapman Ave Ste 617
Fullerton, CA 92831-3621

Phone

(714) 992-4656

Fax

(714) 992-4673

NPI assigned

Dec 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• High Hopes Counseling Foundation, Inc

  • Marriage & Family Therapist
  • Tustin, CA
  • NPI 1164036240
  NPD (past)
• McCandless Family Counseling, Inc.

  • Marriage & Family Therapist
  • Fullerton, CA
  • NPI 1720108558
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124196555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 E CHAPMAN AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313805",
            "telephone_number": "714-992-4656",
            "fax_number": "714-992-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 E CHAPMAN AVE STE 617",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313621",
            "telephone_number": "714-992-4656",
            "fax_number": "714-992-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKLEY",
        "first_name": "JODI",
        "credential": "L.M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC41465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Bittner
• Angela Marie Bivona
• Teresa Sue Black-Coles
• Ellie Marie Black
• Marshanai Black
• Nicholas Riley Blair
• Nicholas Blake, RADT
• Blakemore California Chiropractic Office, Inc.
• James Blakemore, D.C.
• Milan Blalock

• Marriage & Family Therapist in Fullerton, CA
• Providers in Fullerton, 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 Jul 8, 2007; 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.