Individual provider Active NPI

Kevin O'Bryan, LMFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1336816396
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
119828 Issued in CA
Practice address
143 N Larchmont Blvd FL 2
Los Angeles, CA 90004-3704
Phone
(706) 538-8255
NPI assigned
Aug 26, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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 119828 CA Primary

Addresses

Primary practice location

143 N Larchmont Blvd FL 2
Los Angeles, CA 90004-3704

Mailing address

5050 E 2ND St Unit 41114
Long Beach, CA 90853-5439
Phone (706) 538-8255

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

NPI Registry JSON

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1336816396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 E 2ND ST UNIT 41114",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908535439",
            "telephone_number": "706-538-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 N LARCHMONT BLVD FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043704",
            "telephone_number": "706-538-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRYAN",
        "first_name": "KEVIN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-26",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "119828",
            "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 Mar 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.