Lisa Ellen Bograd, MFT

Primary specialty

SpecialistTaxonomy code 174400000X

License

MFC39608 Issued in CA

Practice address

2936 Domingo Ave
Berkeley, CA 94705-2443

Phone

(415) 820-3920

NPI assigned

Apr 10, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780807586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5928 ASCOT DR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946112705",
            "telephone_number": "510-530-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2936 DOMINGO AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052443",
            "telephone_number": "415-820-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGRAD",
        "first_name": "LISA",
        "middle_name": "ELLEN",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "MFC39608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Christine Bodor-Billings, M.D.
• Gabrielle Bodzin, LCSW
• Wolfgang Boeck, DDS
• Nina G Boeddeker, L.AC.
• Gregory C Bogart, PH.D, MFT
• Shelly Catherine Boismenu, MFT
• Lindsey Bolar
• Jessica Bolber
• Susan M. Bolea, LMFT
• Suzan Bollich

• Specialist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Specialist 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.