Active NPI
Jessica Kohanbash
- Clinical Social Worker
- Mission Hills, CA
National Provider Identifier
1629621784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW76091
- Practice address
- 10200 Sepulveda Blvd Ste 180
Mission Hills, CA 91345-2654 - Phone
- (310) 995-0237
- NPI assigned
- Jul 18, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW76091 | CA | Primary |
Addresses
Primary practice location
10200 Sepulveda Blvd Ste 180
Mission Hills, CA 91345-2654
Mailing address
1464 Beverwil Dr
Los Angeles, CA 90035-2909
Phone (310) 995-0237
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW76091 | CA | MD | Clinical Social Worker |
| 76091 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563408000000",
"number": "1629621784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1464 BEVERWIL DR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900352909",
"telephone_number": "310-995-0237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10200 SEPULVEDA BLVD STE 180",
"city": "MISSION HILLS",
"state": "CA",
"postal_code": "913452654",
"telephone_number": "310-995-0237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHANBASH",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-18",
"last_updated": "2019-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW76091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.