Individual provider Active NPI

Michelle S Bilotta-Smith, PSY.D, LMFT

  • Psychologist
  • Los Angeles, CA
National Provider Identifier
1386778504
Registry record updated Feb 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY 24756 Issued in CA
Practice address
1200 Wilshire Blvd Ste 210
Los Angeles, CA 90017-1931
Phone
(213) 481-1347
NPI assigned
Mar 16, 2007
Last updated
Feb 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY 24756 CA Primary
Marriage & Family Therapist 106H00000X MFC41694 CA

Addresses

Primary practice location

1200 Wilshire Blvd Ste 210
Los Angeles, CA 90017-1931

Mailing address

1311 Centinela Ave Apt 8
Santa Monica, CA 90404-2673
Phone (310) 663-6638

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
I20231227002431 CA Practitioner - Marriage and Family Therapist 5496905200 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 24756CAMDPsychologist
MFC41694CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

17707 Studebaker Rd
Cerritos, CA 90703
Phone (562) 402-0688

17707 Studebaker Rd
#150
Cerritos, CA 90703
Phone (310) 402-0688

10515 Balboa Blvd
Granada Hills, CA 91344
Phone (818) 486-3837

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330214400000",
    "number": "1386778504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 CENTINELA AVE APT 8",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042673",
            "telephone_number": "310-663-6638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 WILSHIRE BLVD STE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171931",
            "telephone_number": "213-481-1347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILOTTA-SMITH",
        "first_name": "MICHELLE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PSY.D, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2012-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 24756",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC41694",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.