Richard Brode Travis, PH.D.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT14361 Issued in CA

Practice address

11712 Moorpark St
205B
Studio City, CA 91604-2154

Phone

(818) 766-5988

Fax

(818) 766-1104

NPI assigned

Mar 28, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1053583179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11712 MOORPARK ST",
            "address_2": "205B",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916042154",
            "telephone_number": "818-766-5988",
            "fax_number": "818-766-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11712 MOORPARK ST",
            "address_2": "205B",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916042154",
            "telephone_number": "818-766-5988",
            "fax_number": "818-766-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "RICHARD",
        "middle_name": "BRODE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-28",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT14361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Studio City, CA
• Providers in Studio City, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; 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.