Individual provider Active NPI

Sue Brekka, MFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1194963991
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
45546 Issued in CA
Practice address
12301 Wilshire Blvd Ste 515
Los Angeles, CA 90025-1051
Phone
(310) 923-1517
NPI assigned
Feb 2, 2009
Last updated
Jun 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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 45546 CA Primary

Addresses

Primary practice location

12301 Wilshire Blvd Ste 515
Los Angeles, CA 90025-1051

Mailing address

12301 Wilshire Blvd Ste 515
Los Angeles, CA 90025-1051
Phone (310) 923-1517

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
I20240212000093 CA Practitioner - Marriage and Family Therapist 3870744188 Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Los Angeles, CA 90034
Phone (310) 923-1517

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1194963991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 WILSHIRE BLVD STE 515",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251051",
            "telephone_number": "310-923-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 WILSHIRE BLVD STE 515",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251051",
            "telephone_number": "310-923-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREKKA",
        "first_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-02",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "45546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.