Individual provider Active NPI

Brianne Marie Pennings

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1154974327
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
121832 Issued in CA
Practice address
1963 4TH Ave
San Diego, CA 92101-2394
Phone
(619) 233-3432
NPI assigned
Jul 17, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X 121832 CA Primary

Addresses

Primary practice location

1963 4TH Ave
San Diego, CA 92101-2394

Mailing address

1963 4TH Ave
San Diego, CA 92101-2394
Phone (858) 278-3292

Other practice location 1

4660 Viewridge Ave
San Diego, CA 92123-1638
Phone (858) 278-3292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250626001413 CA Practitioner - Marriage and Family Therapist 4082126701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mood Clinical, P. C.Group PAC ID 4981080769, 107 clinicians

Practice addresses (Care Compare)

18191 Von Karman Ave
Suite 100
Irvine, CA 92612-7103
Phone (619) 639-9730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
121832CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mood Clinical, P. C. CurrentSince Apr 14, 2025 Accepting new patients
Community Research Foundation Inc PastSince Aug 30, 2020 Accepting new patients
Community Research Foundation Inc PastSince Aug 30, 2020 Accepting new patients
Glenn Medical Center, LLC PastSince Apr 14, 2025 Accepting new patients

Locations

18191 Von Karman Ave
Ste 100
Irvine, CA 92612
Phone (530) 889-7293

50 California St
Ste 1500
San Francisco, CA 94111
Phone (310) 648-0700

980 W 17th St
Ste C
Santa Ana, CA 92706
Phone (714) 494-1867

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1154974327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1963 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012394",
            "telephone_number": "858-278-3292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1963 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012394",
            "telephone_number": "619-233-3432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4660 Viewridge Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921231638",
            "country_code": "US",
            "telephone_number": "858-278-3292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENNINGS",
        "first_name": "BRIANNE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "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": "121832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.