Organization Active NPI

Daybreak Medical PA

  • Mental Health Counselor
  • Dallas, TX
National Provider Identifier
1255060091
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
DAYBREAK MEDICAL PA
Practice address
325 N Saint Paul St Ste 3100
Dallas, TX 75201-3923
Phone
(415) 992-6155
Fax
(650) 360-6913
NPI assigned
Jun 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Authorized official

Name
Dr. Takashi Nakamura, MD
Title
Owner
Phone
(415) 992-6155

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X
Family PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TF0000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X
Community/Behavioral Health Agency 251S00000X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

325 N Saint Paul St Ste 3100
Dallas, TX 75201-3923

Mailing address

447 Sutter St Ste 405
San Francisco, CA 94108-4618
Phone (415) 992-6155

Other practice location 1

715 E 3900 S Ste 200D
Millcreek, UT 84107-2557
Phone (415) 992-6155

Other practice location 2

1431 Elizabeth Ave
Charlotte, NC 28204-2506
Phone (415) 992-6155

Other practice location 3

1455 NW Leary Way Ste 400
Seattle, WA 98107-5138
Phone (415) 992-6155

Other practice location 4

4445 Willard Ave Ste 600
Chevy Chase, MD 20815-3786
Phone (415) 992-6155

Other practice location 5

332 S Michigan Ave Ste 900
Chicago, IL 60604-4393
Phone (415) 992-6155

Other practice location 6

3455 Peachtree Rd NE Fl 5
Atlanta, GA 30326-3254
Phone (415) 992-6155

National Provider Directory

National Provider Directory

Locations

4445 Willard Ave
Ste 600
Chevy Chase, MD 20815
Phone (202) 921-4287

1431 Elizabeth Ave
Charlotte, NC 28204

715 E 3900 S
Ste 200D
Millcreek, UT 84107

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734652800000",
    "number": "1255060091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 SUTTER ST STE 405",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941084618",
            "telephone_number": "415-992-6155",
            "fax_number": "650-360-6913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N SAINT PAUL ST STE 3100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752013923",
            "telephone_number": "415-992-6155",
            "fax_number": "650-360-6913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 E 3900 S Ste 200D",
            "address_purpose": "LOCATION",
            "city": "Millcreek",
            "state": "UT",
            "postal_code": "841072557",
            "country_code": "US",
            "telephone_number": "415-992-6155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1431 Elizabeth Ave",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042506",
            "country_code": "US",
            "telephone_number": "415-992-6155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1455 NW Leary Way Ste 400",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981075138",
            "country_code": "US",
            "telephone_number": "415-992-6155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4445 Willard Ave Ste 600",
            "address_purpose": "LOCATION",
            "city": "Chevy Chase",
            "state": "MD",
            "postal_code": "208153786",
            "country_code": "US",
            "telephone_number": "415-992-6155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "332 S Michigan Ave Ste 900",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606044393",
            "country_code": "US",
            "telephone_number": "415-992-6155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3455 Peachtree Rd NE Fl 5",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303263254",
            "country_code": "US",
            "telephone_number": "415-992-6155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DAYBREAK MEDICAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-07",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A",
        "authorized_official_last_name": "NAKAMURA",
        "authorized_official_first_name": "TAKASHI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-992-6155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.