NPIMap

Organization Active NPI

La Mer Psychiatric Medical Group, Inc.

  • Group Psychotherapy Psychologist
  • Oxnard, CA
National Provider Identifier
1346327517
Registry record updated Sep 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
Legal business name
LA MER PSYCHIATRIC MEDICAL GROUP, INC.
Practice address
1901 Outlet Center Dr
Suite 220
Oxnard, CA 93036-0663
Phone
(805) 388-8330
Fax
(805) 388-8030
NPI assigned
Nov 1, 2006
Last updated
Sep 5, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2014

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

Authorized official

Name
Jerry Bruns, M.D.NPI 1851402184
Title
Medical Director
Phone
(805) 388-8330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy Psychologist 103TP2701X NU Primary
Acupuncturist 171100000X NU

Addresses

Primary practice location

1901 Outlet Center Dr
Suite 220
Oxnard, CA 93036-0663

Mailing address

PO Box 201
Camarillo, CA 93011-0201
Phone (805) 388-8330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040126000339 CA Part B Supplier - Clinic/Group Practice 4981504818 Receives reassigned benefits from 2 practitioners
Practice locations: Oxnard, CA

National Provider Directory

National Provider Directory

Locations

333 N Lantana St
Ste 273
Camarillo, CA 93010
Phone (805) 388-8330

601 E Daily Dr
Ste 128
Camarillo, CA 93010

1901 Outlet Center Dr
Ste 220
Oxnard, CA 93036
Phone (805) 388-8330

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409875200000",
    "number": "1346327517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 201",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930110201",
            "telephone_number": "805-388-8330",
            "fax_number": "805-388-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 OUTLET CENTER DR",
            "address_2": "SUITE 220",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930360663",
            "telephone_number": "805-388-8330",
            "fax_number": "805-388-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA MER PSYCHIATRIC MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-09-05",
        "status": "A",
        "authorized_official_last_name": "BRUNS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "805-388-8330",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.