Individual provider Active NPI

Angela Braver, LCSW MFT

  • Clinical Social Worker
  • Culver City, CA
National Provider Identifier
1164584405
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS7770 Issued in CA
Practice address
9696 Culver Blvd Ste 303
Culver City, CA 90232-2759
Phone
(818) 762-3200
Fax
(818) 762-7208
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC15134 CA
Clinical Social Worker 1041C0700X LCS7770 CA Primary

Addresses

Primary practice location

9696 Culver Blvd Ste 303
Culver City, CA 90232-2759

Mailing address

PO Box 548
Culver City, CA 90232-0548

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
I20040812000740 CA Practitioner - Clinical Social Worker 2365414901 Practice locations: Culver City, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9696 Culver Blvd
Suite 303
Culver City, CA 90232-2759
Phone (818) 762-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS7770CAMDClinical Social Worker
MFC15134CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1164584405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 548",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902320548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9696 CULVER BLVD STE 303",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322759",
            "telephone_number": "818-762-3200",
            "fax_number": "818-762-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVER",
        "first_name": "ANGELA",
        "credential": "LCSW MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC15134",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS7770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.