Individual provider Active NPI

Anne Rayne Brodell, MA LMFT

  • Marriage & Family Therapist
  • Palo Alto, CA
National Provider Identifier
1053076026
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
25357 Issued in CA
Practice address
1810 Birch St
Palo Alto, CA 94306-1103
Phone
(650) 299-8585
NPI assigned
Nov 4, 2021
Last updated
Nov 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 25357 CA Primary

Addresses

Primary practice location

1810 Birch St
Palo Alto, CA 94306-1103

Mailing address

1810 Birch St
Palo Alto, CA 94306-1103
Phone (650) 299-8585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 28, 2024 through Feb 29, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
25357CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1053076026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 BIRCH ST",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061103",
            "telephone_number": "650-299-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 BIRCH ST",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061103",
            "telephone_number": "650-299-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODELL",
        "first_name": "ANNE",
        "middle_name": "RAYNE",
        "name_prefix": "Ms.",
        "credential": "MA LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-04",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "25357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.