Individual provider Active NPI

Brian Evan Bruker, LCSW

  • Clinical Social Worker
  • El Monte, CA
National Provider Identifier
1235423906
Registry record updated May 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
24735 Issued in CA
Practice address
9320 Telstar Ave
El Monte, CA 91731-2816
Phone
(213) 842-3828
NPI assigned
May 30, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 24735 CA Primary

Addresses

Primary practice location

9320 Telstar Ave
El Monte, CA 91731-2816

Mailing address

9320 Telstar Ave
El Monte, CA 91731-2816
Phone (213) 842-3828

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

NPI Registry JSON

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

{
    "created_epoch": "1306713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306713600000",
    "number": "1235423906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9320 TELSTAR AVE",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917312816",
            "telephone_number": "213-842-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9320 TELSTAR AVE",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917312816",
            "telephone_number": "213-842-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUKER",
        "first_name": "BRIAN",
        "middle_name": "EVAN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-30",
        "last_updated": "2011-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "24735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Monte, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.