Active NPI
Lauren Blalock Bochner, AMFT
- Mental Health Counselor
- Los Angeles, CA
National Provider Identifier
1992309843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 104087
- Practice address
- 11980 San Vicente Blvd Ste 909
Los Angeles, CA 90049-6607 - Phone
- (213) 537-6727
- NPI assigned
- Nov 22, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 104087 | CA | Primary |
Addresses
Primary practice location
11980 San Vicente Blvd Ste 909
Los Angeles, CA 90049-6607
Mailing address
1198 S Bronson Ave
Los Angeles, CA 90019-3236
Phone (312) 848-5706
Other names 1
- Lauren Blalock
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 30, 2024 through Jan 30, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104087 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606003200000",
"number": "1992309843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1198 S BRONSON AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900193236",
"telephone_number": "312-848-5706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11980 SAN VICENTE BLVD STE 909",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900496607",
"telephone_number": "213-537-6727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLALOCK BOCHNER",
"first_name": "LAUREN",
"credential": "AMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-22",
"last_updated": "2020-11-22",
"certification_date": "2020-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "104087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LAUREN",
"last_name": "BLALOCK",
"credential": "AMFT",
"code": "2",
"type": "Professional Name"
}
]
}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 Nov 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.