Theodora Blanchfield, AMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

133602 Issued in CA

Practice address

4236 Overland Ave
Culver City, CA 90230-3736

Phone

(424) 265-9943

NPI assigned

Apr 10, 2023

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

Other identifiers 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jiva Mental Health

  • Clinical Social Worker
  • Culver City, CA
  • NPI 1699532127
  NPD

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1659066033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 NEILSON WAY APT 1628",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904054023",
            "telephone_number": "917-514-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4236 OVERLAND AVE",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902303736",
            "telephone_number": "424-265-9943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCHFIELD",
        "first_name": "THEODORA",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "133602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASSOCIATE MARRIAGE AND FAMILY THERAPIST",
            "identifier": "133602",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Black
• Tamala Black, LMFT#115219
• Ciara Chanel Woodard Blackwell
• Myisha Lalease Blackwell
• Jennifer S.T. Blair, LCSW
• Laura Blanco
• John Berenson Blanton, D.D.S.
• Sara Michelle Bleak
• Betsy E. Blechman, M.D.
• Blessed Orthopedic Physical Therapy Inc.

• Marriage & Family Therapist in Culver City, CA
• Providers in Culver City, 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 Apr 10, 2023; 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.