Individual provider Active NPI

Theresa Brenner-Farrell, LMFT

  • Marriage & Family Therapist
  • Ventura, CA
National Provider Identifier
1568901130
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
111434 Issued in CA
Practice address
260 Maple CT Ste 250
Ventura
Ventura, CA 93003-3571
Phone
(805) 216-2369
NPI assigned
Feb 15, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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 111434 CA Primary
Mental Health Counselor 101YM0800X IMF83550 CA

Addresses

Primary practice location

260 Maple CT Ste 250
Ventura
Ventura, CA 93003-3571

Mailing address

390 Walnut Dr
Ventura, CA 93003-2054
Phone (805) 216-2369

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
IMF83550CAMDMental Health Counselor
111434CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Together Family Therapy Marriage & Family Therapist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1568901130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 WALNUT DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032054",
            "telephone_number": "805-216-2369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 MAPLE CT STE 250",
            "address_2": "VENTURA",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033571",
            "telephone_number": "805-216-2369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNER-FARRELL",
        "first_name": "THERESA",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-15",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "111434",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF83550",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.