Sophia Camille Boissevain, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

149492 Issued in CA

Practice address

4341 1/2 Clarissa Ave
Los Angeles, CA 90027-2801

Phone

(650) 906-8628

NPI assigned

Aug 23, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1750165361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 GENOA PL APT 3",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941333429",
            "telephone_number": "650-906-8628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4341 1/2 CLARISSA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900272801",
            "telephone_number": "650-906-8628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOISSEVAIN",
        "first_name": "SOPHIA",
        "middle_name": "CAMILLE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-23",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "149492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nelson Antonio Bohorquez, OT STUDENT
• Jonathan Avram Boiarsky
• Mantsha Boikanyo, PSYD
• Sean Nicholas Boileau, PH.D.
• Miranda Diane Boisclair, PHARMD
• Tim Boissey
• Marineh Bojalian, M.D.
• Emi Konuma Bojan
• Markian Bojko
• Ludmila Bojman, MD

• 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 Sep 19, 2024; 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.