Individual provider Active NPI

Mosi Jamila Blane

  • Marriage & Family Therapist
  • Anaheim, CA
National Provider Identifier
1740010636
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
146319 Issued in CA
Practice address
1360 S Anaheim Blvd Ste 101
Anaheim, CA 92805-6258
Phone
(714) 948-7671
NPI assigned
Aug 5, 2024
Last updated
Feb 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 16311 CA
Marriage & Family Therapist 106H00000X 146319 CA Primary

Addresses

Primary practice location

1360 S Anaheim Blvd Ste 101
Anaheim, CA 92805-6258

Mailing address

12564 Central Ave # 738a
Chino, CA 91710-3573

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16311CAMDMental Health Counselor
146319CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1740010636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12564 CENTRAL AVE # 738A",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917103573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 S ANAHEIM BLVD STE 101",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928056258",
            "telephone_number": "714-948-7671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANE",
        "first_name": "MOSI",
        "middle_name": "JAMILA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-05",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "16311",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "146319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.