Individual provider Active NPI

Lawrence Braslow Jr., M.D.

  • Psychiatry Physician
  • Fresno, CA
National Provider Identifier
1588794986
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A42773 Issued in CA
Practice address
6051 N Fresno St Ste 201
Fresno, CA 93710-5280
Phone
(323) 766-2360
Fax
(323) 766-2371
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A42773 CA Primary

Addresses

Primary practice location

6051 N Fresno St Ste 201
Fresno, CA 93710-5280

Mailing address

1411 Silvius Ave
San Pedro, CA 90731-6039
Phone (310) 831-1569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160307001839 CA Practitioner - Psychiatry 5395041024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
First Step Family Counseling IncGroup PAC ID 9234371436, 2 clinicians

Practice addresses (Care Compare)

624 W 9TH St
Suite 103
San Pedro, CA 90731-3158
Phone (310) 938-4575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
42773CAMDMarriage & Family Therapist
A42773CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Step Family Counseling, Inc. CurrentSince Mar 7, 2016 Accepting new patients

Locations

624 W 9th St
Ste 103
San Pedro, CA 90731
Phone (310) 518-4279

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1588794986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 SILVIUS AVE",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907316039",
            "telephone_number": "310-831-1569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6051 N FRESNO ST STE 201",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105280",
            "telephone_number": "323-766-2360",
            "fax_number": "323-766-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASLOW",
        "first_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A42773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.