Ms Jacqueline Leah Bloom-genevitz, PSYD, MFT in Los Angeles, CA - Marriage & Family Therapist

Ms Jacqueline Leah Bloom-genevitz, PSYD, MFT is a Marriage & Family Therapist based in Los Angeles, California. Ms Jacqueline Leah Bloom-genevitz is licensed to practice in California (license number MFT 43614) and her current practice location is 12340 Santa Monica Blvd Ste 214, Los Angeles, California. She can be reached at her office (for appointments etc.) via phone at (310) 582-1513.

NPI number for Ms Jacqueline Leah Bloom-genevitz is 1073652327 and her current mailing address is 464 S Central Ave, Glendale, California. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1073652327.

Contact Information

	Ms Jacqueline Leah Bloom-genevitz, PSYD, MFT
	12340 Santa Monica Blvd Ste 214, Los Angeles, CA 90025
	(310) 582-1513
	(818) 394-6910

Healthcare Provider's Profile

Full Name	Ms Jacqueline Leah Bloom-genevitz
Gender	Female
Speciality	Marriage & Family Therapist
Location	12340 Santa Monica Blvd Ste 214, Los Angeles, California
Accepts Medicare Assignments	Does not participate in Medicare Program. She may not accept medicare assignment.

NPI Data:

NPI Number: 1073652327
Provider Enumeration Date: 02/05/2007
Last Update Date: 05/19/2022

Medical Identifiers

Medical identifiers for Ms Jacqueline Leah Bloom-genevitz such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1073652327	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	(* (Not Available))	Secondary
106H00000X	Marriage & Family Therapist	MFT 43614 (California)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Jacqueline Leah Bloom-genevitz is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Ms Jacqueline Leah Bloom-genevitz, PSYD, MFT 464 S Central Ave, Glendale, CA 91204-1602 Ph: (310) 582-1513	Ms Jacqueline Leah Bloom-genevitz, PSYD, MFT 12340 Santa Monica Blvd Ste 214, Los Angeles, CA 90025 Ph: (310) 582-1513

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Ms Jacqueline Leah Bloom-genevitz, PSYD, MFT - in Los Angeles, CA