Active NPI
Julie Anderson
- Marriage & Family Therapist
- Santa Monica, CA
National Provider Identifier
1407568769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 136580
- Practice address
- 2641 4TH St Apt 1
Santa Monica, CA 90405-4248 - Phone
- (917) 951-9767
- NPI assigned
- Dec 19, 2022
- Sex
- Female
- Sole proprietor
- No
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 | 136580 | CA | Primary |
Addresses
Primary practice location
2641 4TH St Apt 1
Santa Monica, CA 90405-4248
Mailing address
PO Box 5047
Santa Monica, CA 90409-5047
Phone (917) 951-9767
Other practice location 1
3880 S Bascom Ave Ste 216
San Jose, CA 95124-2675
Phone (424) 645-1616
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 18, 2024 through Nov 18, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 136580 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671408000000",
"number": "1407568769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5047",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904095047",
"telephone_number": "917-951-9767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2641 4TH ST APT 1",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904054248",
"telephone_number": "917-951-9767"
}
],
"practiceLocations": [
{
"address_1": "3880 S Bascom Ave Ste 216",
"address_purpose": "LOCATION",
"city": "San Jose",
"state": "CA",
"postal_code": "951242675",
"country_code": "US",
"telephone_number": "424-645-1616",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDERSON",
"first_name": "JULIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-19",
"last_updated": "2022-12-19",
"certification_date": "2022-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "136580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.