Active NPI
Paul Thomas Brogan, MFT
- Marriage & Family Therapist
- Encino, CA
National Provider Identifier
1366685539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 41959
- Practice address
- 16661 Ventura Blvd
Suite 520
Encino, CA 91436-1914 - Phone
- (818) 501-0513
- NPI assigned
- Apr 17, 2009
- Last updated
- Apr 17, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 41959 | CA | Primary |
Addresses
Primary practice location
16661 Ventura Blvd
Suite 520
Encino, CA 91436-1914
Mailing address
16661 Ventura Blvd
Suite 520
Encino, CA 91436-1914
Phone (818) 501-0513
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 25, 2024 through Jan 25, 2028
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": "1239926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239926400000",
"number": "1366685539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16661 VENTURA BLVD",
"address_2": "SUITE 520",
"city": "ENCINO",
"state": "CA",
"postal_code": "914361914",
"telephone_number": "818-501-0513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16661 VENTURA BLVD",
"address_2": "SUITE 520",
"city": "ENCINO",
"state": "CA",
"postal_code": "914361914",
"telephone_number": "818-501-0513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROGAN",
"first_name": "PAUL",
"middle_name": "THOMAS",
"name_prefix": "Mr.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-04-17",
"last_updated": "2009-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "41959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Encino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.