Active NPI
Jillian Boelke
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1376267906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 4620 Hollywood Blvd
Los Angeles, CA 90027-5408 - Phone
- (323) 642-8157
- NPI assigned
- Sep 27, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | CA | Primary |
Addresses
Primary practice location
4620 Hollywood Blvd
Los Angeles, CA 90027-5408
Mailing address
4620 Hollywood Blvd
Los Angeles, CA 90027-5408
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | N/A |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | www.therapynotes.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 2, 2024 through Feb 2, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664236800000",
"number": "1376267906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4620 HOLLYWOOD BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900275408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4620 HOLLYWOOD BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900275408",
"telephone_number": "323-642-8157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOELKE",
"first_name": "JILLIAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-27",
"last_updated": "2022-09-27",
"certification_date": "2022-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "N/A",
"identifier": "NA",
"state": null
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "www.therapynotes.com",
"affiliation": "N",
"address_1": "4620 Hollywood Blvd",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900275408",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.