NPIMap

Organization Active NPI

Blossom Wellness Spa Inc

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1336858869
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
BLOSSOM WELLNESS SPA INC
Practice address
10642 Santa Monica Blvd Apt 209
Los Angeles, CA 90025-4850
Phone
(323) 879-7809
Fax
(323) 879-3899
NPI assigned
Nov 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Authorized official

Name
Jeanne Prinzivalli, M.A. LMFTNPI 1366749103
Title
President/Owner/LMFT
Phone
(310) 806-5386

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

10642 Santa Monica Blvd Apt 209
Los Angeles, CA 90025-4850

Mailing address

10008 National Blvd # 236
Los Angeles, CA 90034-3809
Phone (323) 879-7809

Other names 2

  • Blossom Wellness Counseling Doing business as
  • Self Care Continuum Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251021002541 CA Part B Supplier - Clinic/Group Practice 9931697190 Receives reassigned benefits from 9 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

10008 National Blvd
Los Angeles, CA 90034
Phone (310) 806-5386

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779753600000",
    "number": "1336858869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10008 NATIONAL BLVD # 236",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900343809",
            "telephone_number": "323-879-7809",
            "fax_number": "323-879-3899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10642 SANTA MONICA BLVD APT 209",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254850",
            "telephone_number": "323-879-7809",
            "fax_number": "323-879-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM WELLNESS SPA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-23",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A",
        "authorized_official_last_name": "PRINZIVALLI",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER/LMFT",
        "authorized_official_telephone_number": "310-806-5386",
        "authorized_official_credential": "M.A. LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blossom Wellness Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Self Care Continuum",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.