Individual provider Active NPI

Carol Ann Brush, PH.D.,MFT

  • Marriage & Family Therapist
  • Santa Ana, CA
National Provider Identifier
1194965186
Registry record updated May 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 30797 Issued in CA
Practice address
1450 N Tustin Ave
Suite 222
Santa Ana, CA 92705-8640
Phone
(714) 972-8404
Fax
(714) 633-8418
NPI assigned
Mar 3, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2009

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 MFC 30797 CA Primary

Addresses

Primary practice location

1450 N Tustin Ave
Suite 222
Santa Ana, CA 92705-8640

Mailing address

1450 N Tustin Ave
Suite 222
Santa Ana, CA 92705-8640
Phone (714) 972-8404

Other identifiers 1

IdentifierTypeStateIssuer
MFC 30797OtherCABOARD OF BEHAVIORAL SCIENCES

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MFC 30797CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243468800000",
    "number": "1194965186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 N TUSTIN AVE",
            "address_2": "SUITE 222",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927058640",
            "telephone_number": "714-972-8404",
            "fax_number": "714-633-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 N TUSTIN AVE",
            "address_2": "SUITE 222",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927058640",
            "telephone_number": "714-972-8404",
            "fax_number": "714-633-8418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUSH",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.,MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-03",
        "last_updated": "2009-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 30797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "MFC 30797",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; 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.