Active NPI
Zachary Resnick
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1912577925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 117612
- Practice address
- 11710 San Vicente Blvd
Los Angeles, CA 90049-5006 - Phone
- (310) 882-9929
- NPI assigned
- Jun 30, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 117612 | CA | Primary |
Addresses
Primary practice location
11710 San Vicente Blvd
Los Angeles, CA 90049-5006
Mailing address
1644 Electric Ave Apt 4
Venice, CA 90291-4864
Phone (310) 592-5558
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 117612 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oh Marriage & Family Therapy Corp | Marriage & Family Therapist | Current | Accepting new patients |
Locations
11710 San Vicente Blvd
Los Angeles, CA 90049
Phone (310) 882-9929
Organizations & group practices 1
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.
-
- Marriage & Family Therapist
- Los Angeles, CA
- NPI 1790364073
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625011200000",
"number": "1912577925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1644 ELECTRIC AVE APT 4",
"city": "VENICE",
"state": "CA",
"postal_code": "902914864",
"telephone_number": "310-592-5558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11710 SAN VICENTE BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900495006",
"telephone_number": "310-882-9929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RESNICK",
"first_name": "ZACHARY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-30",
"last_updated": "2021-06-30",
"certification_date": "2021-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "117612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jun 30, 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.