Active NPI
Jesse Proia
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1972056745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 113966
- Practice address
- 1625 Schrader Blvd
Los Angeles, CA 90028-6213 - Phone
- (323) 993-2946
- NPI assigned
- Jul 28, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Marriage & Family Therapist | 106H00000X | 113966 | CA | Primary |
Addresses
Primary practice location
1625 Schrader Blvd
Los Angeles, CA 90028-6213
Mailing address
1625 Schrader Blvd
Los Angeles, CA 90028-6213
Phone (323) 993-2946
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01536011 | Other | CA | MEDI-CAL |
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 |
|---|---|---|---|
| 113966 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591747200000",
"number": "1972056745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1625 SCHRADER BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900286213",
"telephone_number": "323-993-2946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1625 SCHRADER BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900286213",
"telephone_number": "323-993-2946"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROIA",
"first_name": "JESSE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-28",
"last_updated": "2020-06-10",
"certification_date": "2020-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "113966",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "01536011",
"state": "CA"
}
],
"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 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.