Active NPI
Jessica Ghermezi
- School Psychologist
- Santa Monica, CA
National Provider Identifier
1528607629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 4402
- Practice address
- 3101 Ocean Park Blvd Ste 100
Santa Monica, CA 90405-3029 - Phone
- (310) 402-1564
- NPI assigned
- Jan 6, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| School Psychologist | 103TS0200X | 4402 | CA | Primary |
Addresses
Primary practice location
3101 Ocean Park Blvd Ste 100
Santa Monica, CA 90405-3029
Mailing address
3101 Ocean Park Blvd Ste 100
Santa Monica, CA 90405-3029
Phone (310) 402-1564
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4402 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724112000000",
"number": "1528607629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3101 OCEAN PARK BLVD STE 100",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904053029",
"telephone_number": "310-402-1564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3101 OCEAN PARK BLVD STE 100",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904053029",
"telephone_number": "310-402-1564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHERMEZI",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-06",
"last_updated": "2024-08-20",
"certification_date": "2024-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "CA",
"license": "4402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
- Shirin Ghafouri, PHARMD
- Joshua Jonah Ghaly
- Javid Ghandehari, M.D.
- Marjan Ghanem, PHARMD
- Stephen Ghazikhanian
- Ghozland and Youssef a Medical Corp
- Ghozland and Youssef Anesthesia Medical Group Inc
- Walid H. Ghurabi, D.O.
- Giaquinto Center for Digestive and Chiropractic Health Inc.
- James Richard Giaquinto
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.