Individual provider Active NPI

Robert C Brown, LVN, LPN

  • Mental Health Counselor
  • Costa Mesa, CA
National Provider Identifier
1063675031
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
VN156970 Issued in CA
Practice address
3115 Red Hill Ave
Costa Mesa, CA 92626-4517
Phone
(714) 850-8405
Fax
(714) 850-8455
NPI assigned
Jul 9, 2008
Last updated
Apr 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X VN156970 CA Primary

Addresses

Primary practice location

3115 Red Hill Ave
Costa Mesa, CA 92626-4517

Mailing address

9551 Olympic Dr
Huntington Beach, CA 92646-4842
Phone (714) 968-2095

Other practice location 1

9551 Olympic Dr
Huntington Beach, CA 92646-4842
Phone (714) 968-2095

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
VN156970CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1063675031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9551 OLYMPIC DR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926464842",
            "telephone_number": "714-968-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 RED HILL AVE",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264517",
            "telephone_number": "714-850-8405",
            "fax_number": "714-850-8455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9551 Olympic Dr",
            "address_purpose": "LOCATION",
            "city": "Huntington Beach",
            "state": "CA",
            "postal_code": "926464842",
            "country_code": "US",
            "telephone_number": "714-968-2095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ROBERT",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "LVN, LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-09",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "VN156970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; 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.