Individual provider Active NPI

Leesha Brunson

  • Marriage & Family Therapist
  • Camarillo, CA
National Provider Identifier
1518540996
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
151183 Issued in CA
Practice address
1200 Paseo Camarillo Ste 155
Camarillo, CA 93010-6050
Phone
(805) 708-2119
NPI assigned
May 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 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 151183 CA Primary

Addresses

Primary practice location

1200 Paseo Camarillo Ste 155
Camarillo, CA 93010-6050

Mailing address

622 Lantana St Apt 57
Camarillo, CA 93010-6112
Phone (805) 200-6810

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
151183CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Catalina Family Therapy Inc CurrentSince Jul 28, 2024 Accepting new patients
DMG and Assoc PastSince May 1, 2021 Accepting new patients

Locations

1200 Paseo Camarillo
Ste 155
Camarillo, CA 93010
Phone (805) 708-2119

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1518540996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 LANTANA ST APT 57",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106112",
            "telephone_number": "805-200-6810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 PASEO CAMARILLO STE 155",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106050",
            "telephone_number": "805-708-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNSON",
        "first_name": "LEESHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-03",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "151183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.