Lily Frances Tsutsumida, LMFT, ATR-BC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

106288 Issued in CA

Practice address

2900 Bristol St Ste C208
Costa Mesa, CA 92626

Phone

(949) 478-0206

NPI assigned

Aug 1, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Lily Frances Braverman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 25, 2024 through May 25, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1406851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1396153490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 BRISTOL ST STE C208",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265946",
            "telephone_number": "949-478-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 BRISTOL ST STE C208",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "92626",
            "telephone_number": "949-478-0206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18646 Oxnard St",
            "address_purpose": "LOCATION",
            "city": "Tarzana",
            "state": "CA",
            "postal_code": "913561411",
            "country_code": "US",
            "telephone_number": "818-996-1051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TSUTSUMIDA",
        "first_name": "LILY",
        "middle_name": "FRANCES",
        "name_prefix": "Ms.",
        "credential": "LMFT, ATR-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-01",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "CA",
            "license": "16-384",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "106288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LILY",
            "last_name": "BRAVERMAN",
            "middle_name": "FRANCES",
            "credential": "LMFT, ATR-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Marriage & Family Therapist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.

Verify at the official NPI Registry.