Individual provider Active NPI

Gina Marie Pesapane, LMFT

  • Marriage & Family Therapist
  • Culver City, CA
National Provider Identifier
1548395817
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
52399 Issued in CA
Practice address
3814 Dunn Dr
Culver City, CA 90232-2735
Phone
(310) 892-0417
Fax
(310) 328-0175
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 52399 CA Primary

Addresses

Primary practice location

3814 Dunn Dr
Culver City, CA 90232-2735

Mailing address

118 S Lucia Ave
Apt #3
Redondo Beach, CA 90277-3509
Phone (310) 892-0417

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

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1548395817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 S LUCIA AVE",
            "address_2": "APT #3",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773509",
            "telephone_number": "310-892-0417",
            "fax_number": "310-328-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3814 DUNN DR",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322735",
            "telephone_number": "310-892-0417",
            "fax_number": "310-328-0175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESAPANE",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "52399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.