Tara Jean Boerner, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT45305 Issued in CA

Practice address

19720 Ventura Blvd Ste C
Woodland Hills, CA 91364

Phone

(818) 261-8286

Fax

(818) 963-8727

NPI assigned

May 31, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Tara Jean Gussin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1477814911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19720 VENTURA BLVD STE C",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913642676",
            "telephone_number": "818-261-8286",
            "fax_number": "818-963-8727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19720 VENTURA BLVD STE C",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "91364",
            "telephone_number": "818-261-8286",
            "fax_number": "818-963-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOERNER",
        "first_name": "TARA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-31",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT45305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "GUSSIN",
            "middle_name": "JEAN",
            "prefix": "MRS.",
            "credential": "LMFT 45305",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Marriage & Family Therapist in Woodland Hills, CA
• Providers in Woodland Hills, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.