Individual provider Active NPI

Bridget Quebodeaux, MFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1679087688
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT95062 Issued in CA
Practice address
2532 Barry Ave
Los Angeles, CA 90064-2810
Phone
(310) 475-6038
NPI assigned
Nov 29, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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 LMFT95062 CA Primary

Addresses

Primary practice location

2532 Barry Ave
Los Angeles, CA 90064-2810

Mailing address

2532 Barry Ave
Los Angeles, CA 90064-2810
Phone (310) 403-3540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 27, 2024 through Jan 27, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMFT95062CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1679087688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2532 BARRY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642810",
            "telephone_number": "310-403-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2532 BARRY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642810",
            "telephone_number": "310-475-6038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEBODEAUX",
        "first_name": "BRIDGET",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-29",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT95062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.