Los Angeles Gender Center

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

LOS ANGELES GENDER CENTER

Practice address

11350 Ventura Blvd Ste 201
Studio City, CA 91604-3140

Phone

(530) 513-9473

NPI assigned

Feb 1, 2019

Organization subpart

No

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

Authorized official

Name

Aydin Olson-Kennedy, LCSW

Title

Executive Director

Phone

(530) 513-9473

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sothavy Norodom

  • Marriage & Family Therapist
  • Long Beach, CA
  • NPI 1528525078
  NPD (past)

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

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548979200000",
    "number": "1255896403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 VENTURA BLVD STE 201",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916043140",
            "telephone_number": "530-513-9473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11350 VENTURA BLVD STE 201",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916043140",
            "telephone_number": "530-513-9473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES GENDER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-01",
        "last_updated": "2019-02-01",
        "status": "A",
        "authorized_official_last_name": "OLSON-KENNEDY",
        "authorized_official_first_name": "AYDIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "530-513-9473",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Longs Drug Stores California LLC
• Longview Medical Inc
• Belen Bunda Lontoc, CERTIFIED MASSAGE TH
• Lorrin McCormick LMFT Inc
• Lorrin McCormick LMFT Inc
• George Jacob Lough II, PH.D.
• Juliane Hope Lovich
• Jacquelyn Loya
• Lumicare Therapy
• Lyla Boustani D.D.S. Dental Corporation

• Mental Health Clinic/Center (Including Community Mental Health Center) in Studio City, CA
• Providers in Studio City, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; 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.