Active NPI
Phaizon Wood, MFT
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1275710352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT 24735
- Practice address
- 300 Medical Plaza
Los Angeles, CA 90095-0001 - Phone
- (310) 825-9989
- NPI assigned
- Jan 30, 2008
- Sex
- Male
- Sole proprietor
- No
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 | MFT 24735 | CA | Primary |
Addresses
Primary practice location
300 Medical Plaza
Los Angeles, CA 90095-0001
Mailing address
5767 W Century Blvd
Suite 200
Los Angeles, CA 90045-5632
Phone (310) 825-9989
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT 24735 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345075200000",
"number": "1275710352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD",
"address_2": "SUITE 200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455632",
"telephone_number": "310-825-9989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 MEDICAL PLAZA",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900950001",
"telephone_number": "310-825-9989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "PHAIZON",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-30",
"last_updated": "2012-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFT 24735",
"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 Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.