Individual provider Active NPI

Brandi Nichols, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1346843638
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
122625 Issued in CA
Practice address
11650 Iberia PL Ste 135
San Diego, CA 92128-2456
Phone
(619) 858-3105
Fax
(619) 280-5420
NPI assigned
Nov 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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 122625 CA Primary

Addresses

Primary practice location

11650 Iberia PL Ste 135
San Diego, CA 92128-2456

Mailing address

11650 Iberia PL Ste 135
San Diego, CA 92128-2456
Phone (760) 705-4641

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
I20240613003879 CA Practitioner - Marriage and Family Therapist 5698117224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hope for HealersGroup PAC ID 1052753688, 2 clinicians

Practice addresses (Care Compare)

12396 World Trade Dr
Suite 204
San Diego, CA 92128-3789
Phone (760) 705-4641

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hope for Healers Marriage & Family Therapist CurrentSince May 4, 2024 Accepting new patients

Locations

12396 World Trade Dr
Ste 204
San Diego, CA 92128
Phone (619) 327-9317

11650 Iberia Pl
Ste 135
San Diego, CA 92128
Phone (760) 705-4641

711 Center Dr
San Marcos, CA 92069
Phone (760) 402-9103

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1346843638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11650 IBERIA PL STE 135",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282456",
            "telephone_number": "760-705-4641",
            "fax_number": "310-388-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11650 IBERIA PL STE 135",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282456",
            "telephone_number": "619-858-3105",
            "fax_number": "619-280-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "BRANDI",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "122625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.