Individual provider Active NPI

Jason Michael Brown, LMFT

  • Marriage & Family Therapist
  • Manhattan Beach, CA
National Provider Identifier
1053808428
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
96989 Issued in CA
Practice address
2100 N Sepulveda Blvd Ste 25
Manhattan Beach, CA 90266-2957
Phone
(424) 262-6413
NPI assigned
Apr 20, 2018
Last updated
Apr 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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 96989 CA Primary

Addresses

Primary practice location

2100 N Sepulveda Blvd Ste 25
Manhattan Beach, CA 90266-2957

Mailing address

2100 N Sepulveda Blvd Ste 25
Manhattan Beach, CA 90266-2957
Phone (424) 262-6413

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

State licenses

LicenseStateTypeSpecialty
96989CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1053808428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 N SEPULVEDA BLVD STE 25",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902662957",
            "telephone_number": "424-262-6413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N SEPULVEDA BLVD STE 25",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902662957",
            "telephone_number": "424-262-6413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JASON",
        "middle_name": "MICHAEL",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-20",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "96989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.