Active NPI
Bree Roberts, AMFT 125791
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1295489664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 125791
- Practice address
- 3657 Stoner Ave
Los Angeles, CA 90066-2838 - Phone
- (424) 372-7949
- NPI assigned
- Feb 4, 2022
- 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 | 125791 | CA | Primary |
Addresses
Primary practice location
3657 Stoner Ave
Los Angeles, CA 90066-2838
Mailing address
3319 Keeshen Dr
Los Angeles, CA 90066-1917
Phone (917) 359-3429
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 27, 2024 through Feb 27, 2028
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": "1643932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1295489664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3319 KEESHEN DR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900661917",
"telephone_number": "917-359-3429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3657 STONER AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900662838",
"telephone_number": "424-372-7949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "BREE",
"name_prefix": "Ms.",
"credential": "AMFT 125791",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-04",
"last_updated": "2022-02-04",
"certification_date": "2022-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "125791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.