Individual provider Active NPI

Marilyn Julia Brown, L.M.F.T

  • Marriage & Family Therapist
  • El Segundo, CA
National Provider Identifier
1679759120
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
52309 Issued in CA
Practice address
302 W Grand Ave Ste 7
El Segundo, CA 90245
Phone
(424) 272-1804
NPI assigned
Jan 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 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 52309 CA Primary

Addresses

Primary practice location

302 W Grand Ave Ste 7
El Segundo, CA 90245

Mailing address

302 W Grand Ave Ste 7
El Segundo, CA 90245-5112
Phone (424) 272-1804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 1, 2024 through Jul 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
52309CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1679759120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W GRAND AVE STE 7",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902455112",
            "telephone_number": "424-272-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W GRAND AVE STE 7",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "90245",
            "telephone_number": "424-272-1804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MARILYN",
        "middle_name": "JULIA",
        "credential": "L.M.F.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-15",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "52309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

Verify at the official NPI Registry.