DR. JACK CONNELLA (NPI# 1487847588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487847588 |
| Entity Type | Individual |
| Full Name | DR. JACK CONNELLA |
| Credential | MFT |
| Practice Address |
2125 Arizona Ave Suite 303 Santa Monica CA 90404-1337 |
| Practice Telephone | 3105869698 |
| Mailing Telephone | 3105869698 |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2007-08-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | MFC21290 | CA | Behavioral Health & Social Service Providers |
| Street Address |
2125 ARIZONA AVE SUITE 303 |
| City | SANTA MONICA |
| State | CA |
| Zip Code | 90404-1337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114950060 | Howard R Krauss | Ophthalmology | 2125 Arizona Ave, Santa Monica, CA 90404-1337 | 2006-07-07 |
| 1124639018 | Neil A Martin Md Inc | Neurological Surgery | 2125 Arizona Ave, Santa Monica, CA 90404-1337 | 2020-08-13 |
| 1982240461 | Grace Natalie Mcmanus | Audiologist | 2125 Arizona Ave, Santa Monica, CA 90404-1337 | 2019-11-20 |
| 1821649518 | Natasha Cueto | Nurse Practitioner | 2125 Arizona Ave, Santa Monica, CA 90404-1337 | 2019-09-24 |
| 1083193072 | Sheila Rachel Melekh-shalom | Audiologist | 2125 Arizona Ave, Santa Monica, CA 90404-1337 | 2018-08-09 |
| 1144656430 | Katherine Andrea Araque Triana | Internal Medicine | 2125 Arizona Ave, Santa Monica, CA 90404-1337 | 2013-09-19 |
| 1124361712 | Akanksha Sharma | Internal Medicine | 2125 Arizona Ave, Santa Monica, CA 90404-1337 | 2013-04-01 |
| 1770816464 | Omid Benjamin Mehdizadeh | Otolaryngology | 2125 Arizona Ave, Santa Monica, CA 90404-1337 | 2009-09-12 |
| 1578707642 | Garni Barkhoudarian | Neurological Surgery | 2125 Arizona Ave, Santa Monica, CA 90404-1337 | 2009-04-20 |
| 1992975171 | Sheila Kaye Segal | Marriage & Family Therapist | 2125 Arizona Ave, Santa Monica, CA 90404-1337 | 2008-03-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306453352 | Jasmine Burton | Physical Therapist | 1714 17th Street, Santa Monica, CA 90404 | 2020-09-24 |
| 1003431685 | Cintia Haydee Ctibor | Behavior Technician | 1869 9th Street, Santa Monica, CA 90404 | 2020-06-10 |
| 1073137261 | Sydney Kristine Valerio | Counselor | 1869 9th St, Santa Monica, CA 90404 | 2020-06-03 |
| 1710507082 | James Gilbert Cunningham | Marriage & Family Therapist | 1708 Olympic Blvd, Santa Monica, CA 90404 | 2020-04-16 |
| 1841763687 | Crystal Monique Mckinley X | Counselor | 1865 9th St, Santa Monica, CA 90404 | 2019-01-04 |
| 1952872749 | Cesar O Munoz | Licensed Vocational Nurse | 1865 9th St., Santa Monica, CA 90404 | 2018-12-06 |
| 1023596574 | Joseph J Pinzone Md Inc | Internal Medicine | 2001 Santa Monica Blvd Ste 1190, Santa Monica, CA 90404 | 2018-08-06 |
| 1548763535 | Alan Rubenstein Dds Inc | Dentist | 1260 15th St., #703, Santa Monica, CA 90404 | 2018-03-15 |
| 1669993382 | Aaron Wilson | Counselor | 1453 16th Street, Santa Monica, CA 90404 | 2017-07-03 |
| 1922472471 | Chianni Lin | Acupuncturist | 2222 Santa Monica Blvd, Ste. 105, Santa Monica, CA 90404 | 2015-11-20 |
| Find all providers in zip 90404 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447851266 | Gloria Alice Lakin | Marriage & Family Therapist | 2720 Neilson Way # 5564, Santa Monica, CA 90405-4060 | 2020-11-06 |
| 1295335420 | Betsy Carol Cantor | Marriage & Family Therapist | 1011 Euclid St Unit E, Santa Monica, CA 90403-4296 | 2020-10-27 |
| 1306444666 | Andrew Cooper Wasser | Marriage & Family Therapist | 2730 Wilshire Blvd Ste 620, Santa Monica, CA 90403-4755 | 2020-10-09 |
| 1386250942 | Allison Nicole Crooks | Marriage & Family Therapist | 2444 Wilshire Blvd Ste 607, Santa Monica, CA 90403-5814 | 2020-09-18 |
| 1902411374 | Maura Tousignant | Marriage & Family Therapist | 1410 15th St Apt 23, Santa Monica, CA 90404-2724 | 2020-09-12 |
| 1285252668 | Erika Morris | Marriage & Family Therapist | 1621 Centinela Ave Apt E, Santa Monica, CA 90404-4262 | 2020-07-11 |
| 1376168658 | Rosa Morrow | Marriage & Family Therapist | 844 Grant St Apt D, Santa Monica, CA 90405-1361 | 2020-06-11 |
| 1992327357 | Kimberly Sandra Benning | Marriage & Family Therapist | 2029 Olympic Blvd Apt 112, Santa Monica, CA 90404-3964 | 2020-05-08 |
| 1710507082 | James Gilbert Cunningham | Marriage & Family Therapist | 1708 Olympic Blvd, Santa Monica, CA 90404 | 2020-04-16 |
| 1487283537 | Stephanie Gilbert | Marriage & Family Therapist | 528 Arizona Ave Ste 220, Santa Monica, CA 90401-1442 | 2020-04-01 |
| Find all providers in SANTA MONICA | ||||
| City | SANTA MONICA |
| Zip Code | 90404 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.