Jessica Blatt Ezor, LMFT #79983

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

B4946538 Issued in CA

Practice address

1772 S Robertson Blvd
Los Angeles, CA 90035-4316

Phone

(310) 694-5590

NPI assigned

Feb 3, 2011

Sex

Female

Sole proprietor

Yes

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

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.

• Living Rebos, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Los Angeles, CA
  • NPI 1366792269
  NPD (past)

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

{
    "created_epoch": "1296691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1689970964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10541 STRATHMORE DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900242540",
            "telephone_number": "310-430-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1772 S ROBERTSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900354316",
            "telephone_number": "310-694-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZOR",
        "first_name": "JESSICA",
        "middle_name": "BLATT",
        "name_prefix": "Mrs.",
        "credential": "LMFT #79983",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-03",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "B4946538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chukwudi Nnamdi Ezeunala
• Candy Obiageli Ezimora, MD
• Jovita Ezirim-Salamialofoje, NP
• Rita N Ezirim, NP
• Ezm Medical Supplies,Inc
• Ezra Kest, M.D., a Professional Corporation
• Chimere Ogbonnia Ezuma, MD
• Amara Jenevin Ezumah, PMHNP MSN, RN
• Behzad Ezzati
• F Grant Buckle MD a Professional Corp

• Marriage & Family Therapist in Los Angeles, CA
• Providers in Los Angeles, 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 Nov 12, 2015; 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.