Bloom Family Wellness Center, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

BLOOM FAMILY WELLNESS CENTER, LLC

Practice address

1733 Haynes LN
Redondo Beach, CA 90278-4720

Phone

(310) 988-9722

NPI assigned

Jun 15, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elizabeth MondayNPI 1104227966

Title

Co-Owner/Founder

Phone

(310) 988-9722

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elizabeth Monday, M.A., BCBA

  • Behavior Analyst
  • Redondo Beach, CA
  • NPI 1104227966
  NPD Authorized official

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623715200000",
    "number": "1912575986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1733 HAYNES LN",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902784720",
            "telephone_number": "310-988-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1733 HAYNES LN",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902784720",
            "telephone_number": "310-988-9722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM FAMILY WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A",
        "authorized_official_last_name": "MONDAY",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "CO-OWNER/FOUNDER",
        "authorized_official_telephone_number": "310-988-9722"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.