Active NPI
Miri Jedeikin, LMFT
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1790306587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 118754
- Practice address
- 1923 1/2 Westwood Blvd Ste 2
Los Angeles, CA 90025-8401 - Phone
- (310) 800-0012
- NPI assigned
- May 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 136243 | CA | |
| Marriage & Family Therapist | 106H00000X | 118754 | CA | Primary |
Addresses
Primary practice location
1923 1/2 Westwood Blvd Ste 2
Los Angeles, CA 90025-8401
Mailing address
1923 1/2 Westwood Blvd Ste 2
Los Angeles, CA 90025-8401
Phone (310) 627-1499
Other names 1
- Miriam Helen Jedeikin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 12, 2024 through Jan 12, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 118754 | CA | MD | Social Worker |
| 136243 | CA | MD | Sports Medicine (Orthopaedic Surgery) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673740800000",
"number": "1790306587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1923 1/2 WESTWOOD BLVD STE 2",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900258401",
"telephone_number": "310-627-1499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1923 1/2 WESTWOOD BLVD STE 2",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900258401",
"telephone_number": "310-800-0012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEDEIKIN",
"first_name": "MIRI",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-03",
"last_updated": "2023-01-15",
"certification_date": "2023-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "136243",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "118754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MIRIAM",
"last_name": "JEDEIKIN",
"middle_name": "HELEN",
"credential": "LMFT",
"code": "5",
"type": "Other Name"
}
]
}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 Jan 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.