Active NPI
Carol Potter, MFC
- Marriage & Family Therapist
- Culver City, CA
National Provider Identifier
1609016070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC37766
- Practice address
- 9696 Culver Blvd.
Suite 303
Culver City, CA 90232-2759 - Phone
- (310) 636-9628
- Fax
- (310) 836-0378
- NPI assigned
- Feb 25, 2009
- Last updated
- Aug 12, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | MFC37766 | CA | Primary |
Addresses
Primary practice location
9696 Culver Blvd.
Suite 303
Culver City, CA 90232-2759
Mailing address
3342 Barbydell Dr
Los Angeles, CA 90064-4810
Phone (310) 636-9628
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 |
|---|---|---|---|
| MFC37766 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281571200000",
"number": "1609016070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3342 BARBYDELL DR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900644810",
"telephone_number": "310-636-9628",
"fax_number": "310-836-0378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9696 CULVER BLVD.",
"address_2": "SUITE 303",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902322759",
"telephone_number": "310-636-9628",
"fax_number": "310-836-0378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "CAROL",
"credential": "MFC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-25",
"last_updated": "2010-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC37766",
"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 Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.