Caroline Suzanne Bryan, APCC, AMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

AMFT116914 Issued in CA

Practice address

1 Quality Dr
Vacaville, CA 95688-9494

Phone

(707) 624-2830

Fax

(707) 624-2831

NPI assigned

Jul 28, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 5, 2024 through Mar 5, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1558034231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 SOLANO SQ # 240",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945102712",
            "telephone_number": "707-567-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 QUALITY DR",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956889494",
            "telephone_number": "707-624-2830",
            "fax_number": "707-624-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "CAROLINE",
        "middle_name": "SUZANNE",
        "credential": "APCC, AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "APCC7925",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "AMFT116914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marc Brown
• Mark Richard Brown, FNP-C
• Samuel J. Brown, MD
• Thomas W. Brown, DO
• Bruce R. Carlton, M.D., Inc.
• Lee Allen Buccinio, PH.D.
• Rose Mary Bueno, PSYD
• John Stephen Bugas, PHD
• Mylinh Bui, PA-C
• Tu-an Bui

• Mental Health Counselor in Vacaville, CA
• Providers in Vacaville, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.