Edward V. Brackenbury, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC 7563 Issued in CA

Practice address

1220 University Dr
Menlo Park, CA 94025-4262

Phone

(659) 324-0619

Fax

(650) 327-9521

NPI assigned

Feb 6, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1296950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296950400000",
    "number": "1164728309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 E GREENWICH PL",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943033417",
            "telephone_number": "650-324-0619",
            "fax_number": "650-327-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 UNIVERSITY DR",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254262",
            "telephone_number": "659-324-0619",
            "fax_number": "650-327-9521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKENBURY",
        "first_name": "EDWARD",
        "middle_name": "V.",
        "name_prefix": "Mr.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-06",
        "last_updated": "2011-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 7563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MFT",
            "identifier": "MFC 7563",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Bowditch, L.AC.
• Richard Kourtney Bowes, M.D.
• Catherine Anna Boyce, MA, LMFT
• Brooke S Boyle, CD
• Narayan Brach, PSY.D.
• Rom Brafman, PHD
• Linda S. Brandewie, RN,CNS
• Danielle Rayzberg Brandys, LMFT
• James Patrick Brennan, MSW
• Emily Diane Breyer, PSYD

• Marriage & Family Therapist in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2011; 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.