Active NPI
Christina Bruni Fondren, LCSW
- Social Worker
- Austin, TX
National Provider Identifier
1609404029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 67920
- Practice address
- 8133 Mesa Dr Ste 104
Austin, TX 78759-8655 - Phone
- (512) 991-2550
- NPI assigned
- Mar 31, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 67920 | TX | Primary |
Addresses
Primary practice location
8133 Mesa Dr Ste 104
Austin, TX 78759-8655
Mailing address
8133 Mesa Dr Ste 104
Austin, TX 78759-8655
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 19, 2023 through Dec 19, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67920 | TX | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667347200000",
"number": "1609404029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8133 MESA DR STE 104",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787598655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8133 MESA DR STE 104",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787598655",
"telephone_number": "512-991-2550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONDREN",
"first_name": "CHRISTINA",
"middle_name": "BRUNI",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-31",
"last_updated": "2022-11-02",
"certification_date": "2022-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TX",
"license": "67920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.