Individual provider Active NPI

Tiffany R Bushnell, AMFT

  • Marriage & Family Therapist
  • Burbank, CA
National Provider Identifier
1164197703
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
118666 Issued in CA
Practice address
3808 W Riverside Dr Ste 400
Burbank, CA 91505-5301
Phone
(323) 609-7805
NPI assigned
Aug 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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 118666 CA Primary

Addresses

Primary practice location

3808 W Riverside Dr Ste 400
Burbank, CA 91505-5301

Mailing address

PO Box 691388
West Hollywood, CA 90069-9388
Phone (310) 902-7137

Other practice location 1

1006 N Doheny Dr Apt 5
West Hollywood, CA 90069-3134
Phone (323) 609-7805

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
118666CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1164197703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 691388",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900699388",
            "telephone_number": "310-902-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 W RIVERSIDE DR STE 400",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915055301",
            "telephone_number": "323-609-7805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1006 N Doheny Dr Apt 5",
            "address_purpose": "LOCATION",
            "city": "West Hollywood",
            "state": "CA",
            "postal_code": "900693134",
            "country_code": "US",
            "telephone_number": "323-609-7805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSHNELL",
        "first_name": "TIFFANY",
        "middle_name": "R",
        "credential": "AMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "118666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.