Active NPI
Mary Connolly Breiner, MFT
- Marriage & Family Therapist
- Agoura Hills, CA
National Provider Identifier
1275748899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT006941
- Practice address
- 30423 Canwood St
#214
Agoura Hills, CA 91301 - Phone
- (818) 889-7782
- NPI assigned
- May 14, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFT006941 | CA | Primary |
Addresses
Primary practice location
30423 Canwood St
#214
Agoura Hills, CA 91301
Mailing address
740 Island View Circle
Port Hueneme, CA 93041
Phone (805) 986-4955
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT006941 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275748899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "740 ISLAND VIEW CIRCLE",
"city": "PORT HUENEME",
"state": "CA",
"postal_code": "93041",
"telephone_number": "805-986-4955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30423 CANWOOD ST",
"address_2": "#214",
"city": "AGOURA HILLS",
"state": "CA",
"postal_code": "91301",
"telephone_number": "818-889-7782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREINER",
"first_name": "MARY",
"middle_name": "CONNOLLY",
"name_prefix": "Mrs.",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFT006941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Agoura Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.