Brooklyn Helene Douglas

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1031 25TH St
San Diego, CA 92102-2102

Phone

(619) 232-6454

NPI assigned

Apr 22, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Los Angeles, CA
  • NPI 1043242563
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1689256380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 KEARNY VILLA RD APT 432",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231985",
            "telephone_number": "925-960-3262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 25TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921022102",
            "telephone_number": "619-232-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "BROOKLYN",
        "middle_name": "HELENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1031 25th St",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921022102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Douglas Dobecki, Medical Doctor, Incorporated (San Diego Pain Institute)
• Douglas M Grosmark DMD Incorporated
• Douglas M Keel DO Inc (Pacific Dermatology & Cosmetic Laser Center)
• Dana Douglas-Hiley, M.S.,CCC
• April Angela Douglas, DPT
• Grace Douglas
• Joaquin Randall Douglas
• Julia R Douglas, RAT
• Malia Douglas, RN
• Meghan Charisse Douglas

• Student in an Organized Health Care Education/Training Program in San Diego, CA
• Providers in San Diego, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; 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.