Individual provider Active NPI

Keeley Estrada, LMFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1295394591
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT130123 Issued in CA
Practice address
1849 Sawtelle Blvd Ste 610
Los Angeles, CA 90025-7013
Phone
(424) 307-5445
NPI assigned
Jun 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT130123 CA Primary

Addresses

Primary practice location

1849 Sawtelle Blvd Ste 610
Los Angeles, CA 90025-7013

Mailing address

1849 Sawtelle Blvd Ste 610
Los Angeles, CA 90025-7013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240626003009 CA Practitioner - Marriage and Family Therapist 1850835257 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT130123CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Counseling Marriage & Family Therapist CurrentSince Jun 1, 2024 Accepting new patients

Locations

11835 W Olympic Blvd
Ste 815E
Los Angeles, CA 90064
Phone (323) 332-9905

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1295394591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 SAWTELLE BLVD STE 610",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 SAWTELLE BLVD STE 610",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257013",
            "telephone_number": "424-307-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "KEELEY",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT130123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.