Jorge Luis Bermudez, AMFT

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

117699 Issued in CA

Practice address

5601 W Slauson Ave Ste 192
Culver City, CA 90230-6569

Phone

(424) 331-9070

NPI assigned

Dec 18, 2023

Sex

Male

Sole proprietor

Yes

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brighter Tomorrow Family Therapy Inc

  • Mental Health Counselor
  • Culver City, CA
  • NPI 1376407841
  NPD
• Kohan International Foundation

  • Marriage & Family Therapist
  • Culver City, CA
  • NPI 1538424049
  NPD

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1891563987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 W ELLIS AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903021248",
            "telephone_number": "310-242-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 W SLAUSON AVE STE 192",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306569",
            "telephone_number": "424-331-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUIS BERMUDEZ",
        "first_name": "JORGE",
        "credential": "AMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "117699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel Lucas Esquivel
• Andrew Thomas Lucas
• Maria Lucas
• Carmen C Lucci
• Leigh-Anne Lui, LEP
• Godofredo Luis
• Isaac Luis
• Tyler Austen Luis
• John Frank Lujan
• Luke W. Deitz M.D., a Professional Corporation

• Clinical Psychologist in Culver City, CA
• Providers in Culver City, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.