Individual provider Active NPI

Brandy C McKay-Jacobs, LMFT

  • Marriage & Family Therapist
  • Riverside, CA
National Provider Identifier
1356122964
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
7140 Indiana Ave
Riverside, CA 92504-4544
Phone
(323) 717-5874
NPI assigned
Oct 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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 Primary

Addresses

Primary practice location

7140 Indiana Ave
Riverside, CA 92504-4544

Mailing address

PO Box 9942
Moreno Valley, CA 92552-1942
Phone (323) 717-5874

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
I20240229001691 CA Practitioner - Marriage and Family Therapist 5799120770 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside Current Accepting new patients
County of Riverside CurrentSince Jan 1, 2024 Accepting new patients
County of Riverside CurrentSince Jan 1, 2024 Accepting new patients

Locations

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

7140 Indiana Ave
Riverside, CA 92504
Phone (909) 358-6035

Organizations & group practices 3

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": "1696896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1356122964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9942",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925521942",
            "telephone_number": "323-717-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7140 INDIANA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925044544",
            "telephone_number": "323-717-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKAY-JACOBS",
        "first_name": "BRANDY",
        "middle_name": "C",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-10",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.