Individual provider Active NPI

Michelle Jo Kubiak, LMFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1770145096
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
53118 Issued in CA
Practice address
10700 Santa Monica Blvd Ste 300
Los Angeles, CA 90025-6587
Phone
(310) 795-8113
NPI assigned
Jul 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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 53118 CA Primary

Addresses

Primary practice location

10700 Santa Monica Blvd Ste 300
Los Angeles, CA 90025-6587

Mailing address

10700 Santa Monica Blvd Ste 300
Los Angeles, CA 90025-6587

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

NPI Registry JSON

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1770145096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 SANTA MONICA BLVD STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 SANTA MONICA BLVD STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256587",
            "telephone_number": "310-795-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBIAK",
        "first_name": "MICHELLE",
        "middle_name": "JO",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "53118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; 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.