Active NPI
Jacob Brown, MA
- Marriage & Family Therapist
- Sausalito, CA
National Provider Identifier
1831616994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 141837
- Practice address
- 378 Sausalito Blvd
Sausalito, CA 94965-2327 - Phone
- (415) 845-1940
- NPI assigned
- Aug 29, 2017
- Last updated
- Dec 5, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 141837 | CA | Primary |
Addresses
Primary practice location
378 Sausalito Blvd
Sausalito, CA 94965-2327
Mailing address
378 Sausalito Blvd
Sausalito, CA 94965-2327
Phone (415) 845-1940
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A0901989 | Other | CA | CALIFORNIA DRIVERS LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 141837 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701734400000",
"number": "1831616994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "378 SAUSALITO BLVD",
"city": "SAUSALITO",
"state": "CA",
"postal_code": "949652327",
"telephone_number": "415-845-1940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "378 SAUSALITO BLVD",
"city": "SAUSALITO",
"state": "CA",
"postal_code": "949652327",
"telephone_number": "415-845-1940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "JACOB",
"name_prefix": "Mr.",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-08-29",
"last_updated": "2023-12-05",
"certification_date": "2023-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "141837",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA DRIVERS LICENSE",
"identifier": "A0901989",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sausalito, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.