Individual provider Active NPI

Bryan Robertson

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1497438766
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
157666 Issued in CA
Practice address
6363 Wilshire Blvd Ste 520
Los Angeles, CA 90048-5727
Phone
(310) 866-0440
NPI assigned
Aug 11, 2023
Last updated
Oct 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 157666 CA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X CA

Addresses

Primary practice location

6363 Wilshire Blvd Ste 520
Los Angeles, CA 90048-5727

Mailing address

1522 Corte Caballo
Upland, CA 91786-5163
Phone (714) 906-1710

Other practice location 1

1207 E Fruit St
Santa Ana, CA 92701-4206
Phone (714) 906-1710

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
157666CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Angeles Psychology Group, a Professional Psychology Corporation Current Accepting new patients

Locations

6363 Wilshire Blvd
Ste 520
Los Angeles, CA 90048
Phone (310) 866-0440

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": "1691712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1497438766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1522 CORTE CABALLO",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865163",
            "telephone_number": "714-906-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6363 WILSHIRE BLVD STE 520",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485727",
            "telephone_number": "310-866-0440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1207 E Fruit St",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927014206",
            "country_code": "US",
            "telephone_number": "714-906-1710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "BRYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-11",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "157666",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; 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.