Active NPI
Jillian Love-Bloom
- Marriage & Family Therapist
- Oakland, CA
National Provider Identifier
1821710849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 143973
- Practice address
- 3001 International Blvd
Oakland, CA 94601-2203 - Phone
- (510) 433-8600
- NPI assigned
- Sep 15, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | CA | ||
| Marriage & Family Therapist | 106H00000X | 143973 | CA | Primary |
Addresses
Primary practice location
3001 International Blvd
Oakland, CA 94601-2203
Mailing address
3200 Adeline St
Berkeley, CA 94703-2407
Phone (510) 601-0203
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": "1663200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710806400000",
"number": "1821710849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 ADELINE ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947032407",
"telephone_number": "510-601-0203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 INTERNATIONAL BLVD",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946012203",
"telephone_number": "510-433-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOVE-BLOOM",
"first_name": "JILLIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-15",
"last_updated": "2024-03-19",
"certification_date": "2024-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "143973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.