Gerard Sobnosky, LMFT, PSYCHOANALYST

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

102697 Issued in CA

Practice address

1150 W Capitol Dr Unit 13
San Pedro, CA 90732-2267

Phone

(424) 337-0339

NPI assigned

Oct 22, 2017

Sex

Male

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

Opted out of Medicare

Yes, effective Feb 11, 2024 through Feb 11, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1508630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1255842811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 W CAPITOL DR UNIT 13",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907322267",
            "telephone_number": "424-337-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 W CAPITOL DR UNIT 13",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907322267",
            "telephone_number": "424-337-0339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBNOSKY",
        "first_name": "GERARD",
        "credential": "LMFT, PSYCHOANALYST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-22",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "102697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in San Pedro, CA
• Providers in San Pedro, 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 Aug 4, 2022; 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.

Verify at the official NPI Registry.