Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Jacqueline Leah Bloom-Genevitz, PSYD, MFT

Individual provider Psychologist · NPI 1073652327

MS. Jacqueline Leah Bloom-Genevitz, PSYD, MFT is a Psychologist in Los Angeles, California. Practices as a sole proprietor and works from 3 locations. Licensed in California.

Licensed in
CA
In the registry since
2007
Specialties on file
2
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.
MFT — Marriage and Family Therapist
A therapist who treats couples and families.

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Practice location Address checks out

12340 Santa Monica Blvd Ste 214
Los Angeles, CA 90025
Phone: (310) 582-1513
Fax: (818) 394-6910
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 464 S Central Ave, Glendale, CA 91204-1602 — (818) 441-3306
  • 7600 E. Graves Ave, Rosemead, CA 91770-3414 — (626) 280-6510

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence MFT 43614 (CA)
Psychologist Taxonomy 103T00000X

Record details

NPI number1073652327
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYD , MFT
Sole proprietorYes
NPI enumeratedFebruary 5, 2007
Last updated in NPPESMay 19, 2022
Certification dateMay 19, 2022

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