John Breazeal, M.S.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

42975 Issued in CA

Practice address

9990 County Farm Rd # 6
Riverside, CA 92503-3542

Phone

(951) 358-7380

NPI assigned

Dec 21, 2006

Last updated

Jul 8, 2007By 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

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Talkspace Provider Network Ca PCGroup PAC ID 7719339548, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Talkspace Provider Network Ca PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
  • NPI 1003506866

  CA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629132717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28399 CHAMPIONS DR",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925848831",
            "telephone_number": "951-623-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9990 COUNTY FARM RD # 6",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033542",
            "telephone_number": "951-358-7380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAZEAL",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "42975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ralph Anthony Bravo
• Brailyn Bray
• Anne Brazdzionis
• Jacqueline Ann Brazil, R.N.
• Shevan Breaux, LMFT
• Carmen Breda
• Dennis R Breese, DPT
• Ryan L. Brenchley, M.D.
• Lorie Brendecke, RDN
• Debra Gean Brennan

• Marriage & Family Therapist in Riverside, CA
• Providers in Riverside, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.