Individual provider Active NPI

Danae Bryn Samson

  • Marriage & Family Therapist
  • Long Beach, CA
National Provider Identifier
1073093589
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
132943 Issued in CA
Practice address
1301 Pine Ave
Long Beach, CA 90813-3124
Phone
(562) 595-1159
NPI assigned
Aug 15, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 117697 CA
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X 132943 CA Primary

Addresses

Primary practice location

1301 Pine Ave
Long Beach, CA 90813-3124

Mailing address

1301 Pine Ave
Long Beach, CA 90813-3124
Phone (562) 595-1159

Other practice location 1

21545 Centre Pointe Pkwy
Santa Clarita, CA 91350-2947
Phone (661) 259-9439

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
117697CAMDMarriage & Family Therapist
132943CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1073093589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PINE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133124",
            "telephone_number": "562-595-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PINE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133124",
            "telephone_number": "562-595-1159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21545 Centre Pointe Pkwy",
            "address_purpose": "LOCATION",
            "city": "Santa Clarita",
            "state": "CA",
            "postal_code": "913502947",
            "country_code": "US",
            "telephone_number": "661-259-9439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMSON",
        "first_name": "DANAE",
        "middle_name": "BRYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "117697",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "132943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; 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.