JEANESSA BLAIR
NPI 1942012380
Marriage & Family Therapist in Fountain Valley, CA
About Jeanessa Blair NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JEANESSA BLAIR (NPI 1942012380) is an individual marriage & family therapist in Fountain Valley, California, licensed in California (LMFT119702) and active in the NPI registry since January 2025. She has opted out of Medicare through January 1, 2028.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Jeanessa Blair has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.
Other Providers at the Same Location NPPES 9
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FOUNTAIN VALLEY, CA 92708
FOUNTAIN VALLEY, CA 92708
FOUNTAIN VALLEY, CA 92708
FOUNTAIN VALLEY, CA 92708
FOUNTAIN VALLEY, CA 92708
FOUNTAIN VALLEY, CA 92708
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jeanessa Blair's NPI number?
The NPI number for Jeanessa Blair is 1942012380. It was assigned to this individual provider in the NPPES registry on January 23, 2025.
Where is Jeanessa Blair located?
Jeanessa Blair practices at 17350 Mount Herrmann St Ste A, Fountain Valley, CA 92708. The listed phone number is (310) 901-2564.
What is Jeanessa Blair's specialty?
The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.
Is Jeanessa Blair enrolled in Medicare?
No. Jeanessa Blair has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Jeanessa Blair was last updated on January 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jeanessa Blair · NPI 1942012380
Marriage & Family Therapist provider in Fountain Valley, California. Individual provider, active in the CMS NPPES registry since January 23, 2025.
## Identity
- **NPI:** 1942012380 (Entity type: Individual)
- **Enumerated:** January 23, 2025
- **Primary specialty:** Marriage & Family Therapist · taxonomy 106H00000X
- **State license:** LMFT119702 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 17350 MOUNT HERRMANN ST STE A, Fountain Valley, CA 92708-4114
- **Phone:** (310) 901-2564
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through January 1, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** January 23, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1942012380) · Data from the CMS NPPES public registry.