Individual provider Active NPI

Jay Earl Bray, L.C.S.W.

  • Mental Health Counselor
  • San Mateo, CA
National Provider Identifier
1467462937
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCSW 5353 Issued in CA
Practice address
520 S El Camino Real
Suite 624
San Mateo, CA 94402-1726
Phone
(650) 562-1144
Fax
(650) 618-1718
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCSW 5353 CA Primary

Addresses

Primary practice location

520 S El Camino Real
Suite 624
San Mateo, CA 94402-1726

Mailing address

520 S El Camino Real
Suite 624
San Mateo, CA 94402-1726
Phone (650) 562-1144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCSW 5353CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364774400000",
    "number": "1467462937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S EL CAMINO REAL",
            "address_2": "SUITE 624",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944021726",
            "telephone_number": "650-562-1144",
            "fax_number": "650-618-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S EL CAMINO REAL",
            "address_2": "SUITE 624",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944021726",
            "telephone_number": "650-562-1144",
            "fax_number": "650-618-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "JAY",
        "middle_name": "EARL",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2013-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LCSW 5353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.