Individual provider Active NPI

Brent Dean Estes, L.M.F.T.

  • Marriage & Family Therapist
  • Los Osos, CA
National Provider Identifier
1083634653
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC32173 Issued in CA
Practice address
900 Los Osos Valley Rd
Suite C
Los Osos, CA 93402-3206
Phone
(805) 528-0605
Fax
(805) 528-0605
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MFC32173 CA Primary

Addresses

Primary practice location

900 Los Osos Valley Rd
Suite C
Los Osos, CA 93402-3206

Mailing address

900 Los Osos Valley Rd
Suite C
Los Osos, CA 93402-3206
Phone (805) 528-0605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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

LicenseStateTypeSpecialty
MFC32173CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083634653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 LOS OSOS VALLEY RD",
            "address_2": "SUITE C",
            "city": "LOS OSOS",
            "state": "CA",
            "postal_code": "934023206",
            "telephone_number": "805-528-0605",
            "fax_number": "805-528-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 LOS OSOS VALLEY RD",
            "address_2": "SUITE C",
            "city": "LOS OSOS",
            "state": "CA",
            "postal_code": "934023206",
            "telephone_number": "805-528-0605",
            "fax_number": "805-528-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTES",
        "first_name": "BRENT",
        "middle_name": "DEAN",
        "credential": "L.M.F.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC32173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Osos, CA

Sources for this page

Verify at the official NPI Registry.