Sara Lynne Boblak

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

144031 Issued in CA

Practice address

4105 E Broadway Ste 202
Long Beach, CA 90803-1503

Phone

(562) 285-6776

NPI assigned

Apr 3, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Blue Chair Foundation

  • Marriage & Family Therapist
  • Redondo Beach, CA
  • NPI 1235974619
  NPD
• 1736 Family Crisis Center

  • Mental Health Counselor
  • Torrance, CA
  • NPI 1104958479
  NPD (past)

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1548722093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 ARTESIA BLVD STE 110",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783265",
            "telephone_number": "310-974-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 E BROADWAY STE 202",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908031503",
            "telephone_number": "562-285-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBLAK",
        "first_name": "SARA",
        "middle_name": "LYNNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "144031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blythe Ventures, Inc (Windsor Gardens Convalescent Center of Long Beach)
• Blythe/Windsor Country Park Healthcare Center, LLC (Windsor Gardens Convalescent Center of Long Beach)
• BMG Inc (Active Adhc)
• Rena Bo
• Alfred Jameson III Boatwright
• Myeshia Bobo, LCSW
• Paul T Bochary, RADT
• Body Philosophy Spa
• Shalanda Body
• Bodyby Ultimate LLC

• Marriage & Family Therapist in Long Beach, CA
• Providers in Long Beach, 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 May 13, 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.

Verify at the official NPI Registry.