MEDICARE: JEREMIAH SOSENKO MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1356272629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEREMIAH SOSENKO MA

Provider Business Mailing Address
First Line	:	1860 LINDA ROSA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-2147
Country	:	US
Telephone Number	:	773-425-6229
Fax Number	:

Provider Business Practice Location Address
First Line	:	7257 BEVERLY BLVD STE 108
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-2567
Country	:	US
Telephone Number	:	323-813-1912
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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Directions to “ JEREMIAH SOSENKO MA” Practice Location

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