Jennifer Ann Bloom, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

141174 Issued in CA

Practice address

1833 12TH St Apt B
Santa Monica, CA 90404-4625

Phone

(424) 275-7252

NPI assigned

Jan 7, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Fig Tree Psychology Center

  • Mental Health Counselor
  • Los Angeles, CA
  • NPI 1699118646
  NPD (past)

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1942961248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1833 12TH ST APT B",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904044625",
            "telephone_number": "424-275-7252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 12TH ST APT B",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904044625",
            "telephone_number": "424-275-7252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-07",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "141174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BBS LMFT REGISTRATION",
            "identifier": "LMFT141174",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• BLC Gardens-Santa Monica LH, LLC
• BLC Ocean House, L.P.
• Jim Blechman, MD
• James Blinstrubas
• Bliss OB/GYN, Inc.
• Rachael Elaine Bloom, LCSW
• Charles Eric Bloomquist
• Caitlin Blue, LMFT
• Christina Blum
• Doron Blumenfeld, MD

• Marriage & Family Therapist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.