Individual provider Active NPI

Breanna Davaran

  • Marriage & Family Therapist
  • Martinez, CA
National Provider Identifier
1023408739
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
80417 Issued in CA
Practice address
10 Douglas Dr Ste 140
Martinez, CA 94553
Phone
(925) 313-1159
Fax
(925) 313-1142
NPI assigned
Feb 2, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X 80417 CA Primary

Addresses

Primary practice location

10 Douglas Dr Ste 140
Martinez, CA 94553

Mailing address

10 Douglas Dr Ste 140
Martinez, CA 94553-4078
Phone (925) 313-1159

Other practice location 1

550 Patterson Blvd
Pleasant Hill, CA 94523-4155
Phone (925) 938-8050 ext. 14451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1422835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1023408739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DOUGLAS DR STE 140",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945534078",
            "telephone_number": "925-313-1159",
            "fax_number": "925-313-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DOUGLAS DR STE 140",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "94553",
            "telephone_number": "925-313-1159",
            "fax_number": "925-313-1142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Patterson Blvd",
            "address_purpose": "LOCATION",
            "city": "Pleasant Hill",
            "state": "CA",
            "postal_code": "945234155",
            "country_code": "US",
            "telephone_number": "925-938-8050 x14451",
            "fax_number": "925-930-8040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVARAN",
        "first_name": "BREANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-02",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "80417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.