Active NPI
Camille Debruin
- Marriage & Family Therapist
- Pismo Beach, CA
National Provider Identifier
1609639905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 142606
- Practice address
- 310 James Way Ste 150
Pismo Beach, CA 93449-2877 - Phone
- (805) 769-8922
- NPI assigned
- Jan 31, 2024
- Last updated
- Jan 31, 2024
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 142606 | CA | Primary |
Addresses
Primary practice location
310 James Way Ste 150
Pismo Beach, CA 93449-2877
Mailing address
11395 Eliano St
Atascadero, CA 93422-6159
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1050 Las Tablas Rd
Suite 2
Templeton, CA 93465-9792
Phone (805) 835-9088
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 142606 | CA | MD | Marriage & Family Therapist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Psychologist
- Atascadero, CA
- NPI 1710782842
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706659200000",
"number": "1609639905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11395 ELIANO ST",
"city": "ATASCADERO",
"state": "CA",
"postal_code": "934226159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 JAMES WAY STE 150",
"city": "PISMO BEACH",
"state": "CA",
"postal_code": "934492877",
"telephone_number": "805-769-8922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBRUIN",
"first_name": "CAMILLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-31",
"last_updated": "2024-01-31",
"certification_date": "2024-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "142606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pismo Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.