Jessica Bromley, MFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

108736 Issued in CA

Practice address

435 Petaluma Ave Ste 134
Sebastopol, CA 95472-4273

Phone

(707) 395-5290

NPI assigned

Dec 26, 2021

Last updated

Dec 26, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1640476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640476800000",
    "number": "1306506860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9198 RIO VISTA RD",
            "city": "FORESTVILLE",
            "state": "CA",
            "postal_code": "954369567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 PETALUMA AVE STE 134",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724273",
            "telephone_number": "707-395-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROMLEY",
        "first_name": "JESSICA",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-26",
        "last_updated": "2021-12-26",
        "certification_date": "2021-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "108736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoe Bradley-Benoit, PSY.D.
• Bruce Robert Bragonier, M.D.
• Allyson L Bray
• Brian Jacobs, Licensed Clinical Social Worker, PC (Sonoma Life Solutions)
• Laurel Anne Brody, L.AC.
• Kathleen Brannan Brown, NP
• Bruce R. Bragonier, MD, a Professional Corporation
• Teresa L Burk, P.T.
• Brittany Ann Burns, ACSW
• Nancy Ramah Burns, L.M.F.T.

• Mental Health Counselor in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.