Individual provider Active NPI

Deborah Kimberly Bryk, LPCC

  • Professional Counselor
  • La Jolla, CA
National Provider Identifier
1306213509
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPCC15041 Issued in CA
Practice address
8950 Villa la Jolla Dr Ste C230
La Jolla, CA 92037-1712
Phone
(925) 282-1778
Fax
(415) 296-5299
NPI assigned
Aug 24, 2015
Last updated
Apr 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X MI
Professional Counselor 101YP2500X LPCC15041 CA Primary

Addresses

Primary practice location

8950 Villa la Jolla Dr Ste C230
La Jolla, CA 92037-1712

Mailing address

8950 Villa la Jolla Dr Ste C230
La Jolla, CA 92037-1712
Phone (925) 282-1778

Other practice location 1

6200 Wilshire Blvd Ste 1410
Los Angeles, CA 90048-5815
Phone (925) 282-1778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240501002980 CA Practitioner - Mental Health Counselor 5991145625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

8950 Villa la Jolla Dr
La Jolla, CA 92037-1712
Phone (925) 282-1778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPCC15041CAMDProfessional Counselor
15041CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc Multi-Specialty CurrentSince Apr 1, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

8950 Villa La Jolla Dr
Ste C230
La Jolla, CA 92037
Phone (206) 906-5385

8881 Fletcher Pkwy
Ste 350
La Mesa, CA 91942
Phone (619) 465-9792

6200 Wilshire Blvd
Ste 1410
Los Angeles, CA 90048
Phone (323) 434-0011

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1306213509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 VILLA LA JOLLA DR STE C230",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371712",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 VILLA LA JOLLA DR STE C230",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371712",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6200 Wilshire Blvd Ste 1410",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900485815",
            "country_code": "US",
            "telephone_number": "925-282-1778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYK",
        "first_name": "DEBORAH",
        "middle_name": "KIMBERLY",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "LPCC15041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.