Brodan Fortuna, CMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

93106 Issued in CA

Practice address

688 Laguna Dr
Simi Valley, CA 93065-5303

Phone

(805) 207-8495

NPI assigned

Jun 12, 2026

Last updated

Jun 12, 2026By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1781222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1588599567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "688 LAGUNA DR",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930655303",
            "telephone_number": "805-207-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688 LAGUNA DR",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930655303",
            "telephone_number": "805-207-8495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1429 E Thousand Oaks Blvd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Thousand Oaks",
            "state": "CA",
            "postal_code": "913626231",
            "country_code": "US",
            "telephone_number": "805-768-4082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORTUNA",
        "first_name": "BRODAN",
        "credential": "CMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-12",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "93106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED MASSAGE LICENSE",
            "identifier": "93106",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; 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.