Individual provider Active NPI

Joelida Brown

  • Marriage & Family Therapist
  • Stockton, CA
National Provider Identifier
1356818728
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
147708 Issued in CA
Practice address
430 N Pilgrim St
Stockton, CA 95205-4428
Phone
(209) 464-1089
NPI assigned
Oct 24, 2018
Last updated
Aug 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 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 147708 CA Primary

Addresses

Primary practice location

430 N Pilgrim St
Stockton, CA 95205-4428

Mailing address

430 N Pilgrim St
Stockton, CA 95205-4428
Phone (209) 464-1089

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
I20241003000889 CA Practitioner - Marriage and Family Therapist 0446781389 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
147708CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
An Elegant Sufficiency, a Psychological Corporation CurrentSince Sep 1, 2024 Accepting new patients

Locations

2431 W March Ln
Ste 200
Stockton, CA 95207
Phone (209) 200-8305

5250 Claremont Ave
Ste 118
Stockton, CA 95207
Phone (209) 200-8305

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1356818728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 N PILGRIM ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952054428",
            "telephone_number": "209-464-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 N PILGRIM ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952054428",
            "telephone_number": "209-464-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JOELIDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "147708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.