Brandon Michael Green

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

525 Cabrillo Park Dr Ste 300
Santa Ana, CA 92701-5017

Phone

(714) 953-4455

NPI assigned

Jul 27, 2020

Last updated

Aug 3, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wave Professional Clinical Counselors IncGroup PAC ID 6305153123, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Wave Professional Clinical Counselors, Inc.

  • Community/Behavioral Health Agency
  • Carlsbad, CA
  • NPI 1700288768

  Marriage & Family Therapist

  Medicare reassignment Care Compare group NPD
• Child Guidance Center, Inc.

  • Community/Behavioral Health Agency
  • Fullerton, CA
  • NPI 1003936311
  NPD (past)

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1548879422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 AVENIDA GRANADA APT A",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926725291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 CABRILLO PARK DR STE 300",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927015017",
            "telephone_number": "714-953-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BRANDON",
        "middle_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary C Graves
• Genevieve Gray
• Kenneth Patrick Grebel, PH.D.
• Green Meadows Home Care
• Green Meadows Home Health Care Inc,
• Danielle Lopez Green
• Madeline Carey Green
• Sara Green
• Benjamin Greenberg
• Matthew L Greenberger, M.D.

• Marriage & Family Therapist in Santa Ana, CA
• Providers in Santa Ana, 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 Aug 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.