Active NPI
Brett Ryan
- Marriage & Family Therapist
- Corona, CA
National Provider Identifier
1083375158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 128956
- Practice address
- 4160 Temescal Canyon Rd Ste 309
Corona, CA 92883-4629 - Phone
- (949) 478-0235
- NPI assigned
- Dec 31, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 128956 | CA | Primary |
Addresses
Primary practice location
4160 Temescal Canyon Rd Ste 309
Corona, CA 92883-4629
Mailing address
4160 Temescal Canyon Rd Ste 309
Corona, CA 92883-4629
Phone (949) 478-0235
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 128956 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1640908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640908800000",
"number": "1083375158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4160 TEMESCAL CANYON RD STE 309",
"city": "CORONA",
"state": "CA",
"postal_code": "928834629",
"telephone_number": "949-478-0235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4160 TEMESCAL CANYON RD STE 309",
"city": "CORONA",
"state": "CA",
"postal_code": "928834629",
"telephone_number": "949-478-0235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "BRETT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-12-31",
"last_updated": "2021-12-31",
"certification_date": "2021-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "128956",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.