Individual provider Active NPI

Brigid S. Ryan, MFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1649590522
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC43260 Issued in CA
Practice address
4525 Montgomery Dr
Ste 14
Santa Rosa, CA 95409
Phone
(707) 327-0244
NPI assigned
Jun 2, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC43260 CA Primary

Addresses

Primary practice location

4525 Montgomery Dr
Ste 14
Santa Rosa, CA 95409

Mailing address

4525 Montgomery Dr
Ste 14
Santa Rosa, CA 95409
Phone (707) 327-0244

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250404000390 CA Practitioner - Marriage and Family Therapist 4082138672 Practice locations: Sebastopol, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFC43260CAMDMarriage & Family Therapist
43260CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1649590522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 MONTGOMERY DR",
            "address_2": "STE 14",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95409",
            "telephone_number": "707-327-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 MONTGOMERY DR",
            "address_2": "STE 14",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95409",
            "telephone_number": "707-327-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "BRIGID",
        "middle_name": "S.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-02",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC43260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.