Active NPI
Elizabeth Brackenbury
- Marriage & Family Therapist
- Pasadena, CA
National Provider Identifier
1841907003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 572 E Green St Ste 206
Pasadena, CA 91101-2075 - Phone
- (626) 765-7506
- NPI assigned
- Oct 27, 2022
- Sex
- Female
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
572 E Green St Ste 206
Pasadena, CA 91101-2075
Mailing address
PO Box 2501
Toluca Lake, CA 91610-0501
Other practice location 1
4241 Cahuenga Blvd Unit 307
Toluca Lake, CA 91602-3626
Phone (626) 243-2589
Other practice location 2
393 N Lake Ave
Pasadena, CA 91101-1213
Phone (626) 844-4794
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705449600000",
"number": "1841907003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2501",
"city": "TOLUCA LAKE",
"state": "CA",
"postal_code": "916100501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "572 E GREEN ST STE 206",
"city": "PASADENA",
"state": "CA",
"postal_code": "911012075",
"telephone_number": "626-765-7506"
}
],
"practiceLocations": [
{
"address_1": "4241 Cahuenga Blvd Unit 307",
"address_purpose": "LOCATION",
"city": "Toluca Lake",
"state": "CA",
"postal_code": "916023626",
"country_code": "US",
"telephone_number": "626-243-2589",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "393 N Lake Ave",
"address_purpose": "LOCATION",
"city": "Pasadena",
"state": "CA",
"postal_code": "911011213",
"country_code": "US",
"telephone_number": "626-844-4794",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRACKENBURY",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-27",
"last_updated": "2024-01-17",
"certification_date": "2024-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.