Individual provider Active NPI

Brandon Jade Breault, LMFT

  • Marriage & Family Therapist
  • Sherman Oaks, CA
National Provider Identifier
1659950723
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
3900 Glenridge Dr
Sherman Oaks, CA 91423-4645
Phone
(646) 239-9257
NPI assigned
Apr 6, 2021
Last updated
Apr 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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 CA Primary

Addresses

Primary practice location

3900 Glenridge Dr
Sherman Oaks, CA 91423-4645

Mailing address

13636 Ventura Blvd # 234
Sherman Oaks, CA 91423-3700
Phone (646) 239-9257

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1659950723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13636 VENTURA BLVD # 234",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914233700",
            "telephone_number": "646-239-9257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 GLENRIDGE DR",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914234645",
            "telephone_number": "646-239-9257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAULT",
        "first_name": "BRANDON",
        "middle_name": "JADE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.