Individual provider Active NPI

Jeanne Marie Abbott Prinzivalli

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1366749103
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
52833 Issued in CA
Practice address
10642 Santa Monica Blvd Apt 209
Los Angeles, CA 90025-4850
Phone
(323) 879-7809
Fax
(323) 879-3899
NPI assigned
Feb 14, 2011
Sex
Female
Sole proprietor
Yes

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 52833 CA Primary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X 165 CA

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 (310) 806-5386

Other identifiers 4

IdentifierTypeStateIssuer
7667OtherCAMEDI-CAL
7184OtherCAMEDI-CAL
7368OtherCAMEDI-CAL
7708OtherCAMEDI-CAL

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
I20251023000840 CA Practitioner - Marriage and Family Therapist 2567950629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10008 National Blvd
Suite 236
Los Angeles, CA 90034-3809

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
165CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Blossom Wellness Spa Inc Marriage & Family Therapist CurrentSince Aug 5, 2025 Accepting new patients

Locations

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

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": "1297641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1366749103",
    "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": "310-806-5386",
            "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": {
        "last_name": "PRINZIVALLI",
        "first_name": "JEANNE",
        "middle_name": "MARIE ABBOTT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-14",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "52833",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "165",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7667",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7184",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7368",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7708",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.