Individual provider Active NPI

Tyeast Monique Brown, M.S

  • Marriage & Family Therapist
  • Lancaster, CA
National Provider Identifier
1306979042
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
83248 Issued in CA
Practice address
42455 10TH St W Ste 103
Lancaster, CA 93534-7060
Phone
(661) 341-3900
Fax
(661) 341-3904
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 83248 CA Primary

Addresses

Primary practice location

42455 10TH St W Ste 103
Lancaster, CA 93534-7060

Mailing address

42455 10TH St W Ste 103
Lancaster, CA 93534-7060
Phone (661) 341-3900

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
I20241231003662 CA Practitioner - Marriage and Family Therapist 3779010863 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Live Well Family Counseling Services Marriage & Family Therapist CurrentSince Dec 1, 2024 Accepting new patients
Pathways Community Services LLC PastSince Mar 1, 2020 Accepting new patients

Locations

275 W Hospitality Ln
Ste 309
San Bernardino, CA 92408
Phone (951) 257-8045

41593 Winchester Rd
Ste 215
Temecula, CA 92590
Phone (951) 257-8045

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1306979042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42455 10TH ST W STE 103",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935347060",
            "telephone_number": "661-341-3900",
            "fax_number": "661-341-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42455 10TH ST W STE 103",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935347060",
            "telephone_number": "661-341-3900",
            "fax_number": "661-341-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TYEAST",
        "middle_name": "MONIQUE",
        "credential": "M.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "83248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.