Victoria Bodell, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

28776 Issued in CA

Practice address

12021 Wilshire Blvd # 333
Los Angeles, CA 90025-1206

Phone

(310) 980-2833

NPI assigned

Nov 11, 2011

Reactivated

Apr 13, 2015

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)

Enrolled

State licenses

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

{
    "created_epoch": "1320969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1710264262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12021 WILSHIRE BLVD.",
            "address_2": "SUITE 333",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90025",
            "telephone_number": "310-980-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12021 WILSHIRE BLVD # 333",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251206",
            "telephone_number": "310-980-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODELL",
        "first_name": "VICTORIA",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-11",
        "last_updated": "2016-07-19",
        "deactivation_date": "2013-11-05",
        "reactivation_date": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "28776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Isaiah Bodden, MD
• Jessica Lynne Bodden, MD
• Kenneth William Boddie, M.D.
• Madhav R Boddula, M.D., M.P.H.
• Georgia Konstandopou Bode, M.D.
• Michelle Elizabeth Boden, DDS
• Mark David Bodenstein, L.C.S.W.
• April Marie Bodily, RN, PMHNP-BC, FNP-C
• Stefanie C Bodison, OTD
• Ross Alan Bodle, MSW

• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; 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.