Ila Breeann 'Bree' Bode, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

47139 Issued in CA

Practice address

5161 Soquel Dr Ste C
Soquel, CA 95073-2560

Phone

(831) 515-7078

Fax

(833) 312-0098

NPI assigned

Apr 13, 2007

Last updated

Oct 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 18, 2025 through Apr 18, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1801011176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5161 SOQUEL DR STE C",
            "city": "SOQUEL",
            "state": "CA",
            "postal_code": "950732560",
            "telephone_number": "831-515-7078",
            "fax_number": "833-312-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5161 SOQUEL DR STE C",
            "city": "SOQUEL",
            "state": "CA",
            "postal_code": "950732560",
            "telephone_number": "831-515-7078",
            "fax_number": "833-312-0098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 Encinal St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Santa Cruz",
            "state": "CA",
            "postal_code": "950602178",
            "country_code": "US",
            "telephone_number": "831-469-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODE",
        "first_name": "ILA",
        "middle_name": "BREEANN 'BREE'",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "47139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MEDICARE GROUP PTAN#",
            "identifier": "ZZZ91892Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bella and Baby Physical Therapy
• Jasmine Debra Berke, L.AC., D.A.O.M.
• Carol Feinfield Berman, LCSW
• Daniel Paul Bitner, MD
• Nancy Black
• Alyssa Bondi, LMFT, ATR
• Susan M Brandy, LCSW
• Nancy Lynn Braunhut, MS, MAT
• Austen Rose Brenton, HHP, DOULA
• Brian Anthony Chiropractic Inc

• Marriage & Family Therapist in Soquel, CA
• Providers in Soquel, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.