Individual provider Active NPI

Joseph Gerald Grossman, MFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1871711853
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC20077 Issued in CA
Practice address
12304 Santa Monica Blvd
214
Los Angeles, CA 90025-2551
Phone
(310) 820-6322
Fax
(310) 820-4432
NPI assigned
Apr 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MFC20077 CA Primary

Addresses

Primary practice location

12304 Santa Monica Blvd
214
Los Angeles, CA 90025-2551

Mailing address

12304 Santa Monica Blvd
214
Los Angeles, CA 90025-2551
Phone (310) 820-6322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 13, 2024 through Mar 13, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC20077CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871711853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12304 SANTA MONICA BLVD",
            "address_2": "214",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252551",
            "telephone_number": "310-820-6322",
            "fax_number": "310-820-4432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12304 SANTA MONICA BLVD",
            "address_2": "214",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252551",
            "telephone_number": "310-820-6322",
            "fax_number": "310-820-4432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "JOSEPH",
        "middle_name": "GERALD",
        "name_prefix": "Mr.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC20077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.