Individual provider Active NPI

Breenu Sra, MFT

  • Marriage & Family Therapist
  • Campbell, CA
National Provider Identifier
1861814832
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC # 53160 Issued in CA
Practice address
51 E Campbell Ave Ste 106I
Campbell, CA 95008-2054
Phone
(408) 568-6455
Fax
(888) 706-4141
NPI assigned
Jan 10, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC # 53160 CA Primary

Addresses

Primary practice location

51 E Campbell Ave Ste 106I
Campbell, CA 95008-2054

Mailing address

859 Washington St # 203
Red Bluff, CA 96080-2704
Phone (408) 568-6455

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

State licenses

LicenseStateTypeSpecialty
MFC # 53160CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1861814832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 WASHINGTON ST # 203",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960802704",
            "telephone_number": "408-568-6455",
            "fax_number": "888-706-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 E CAMPBELL AVE STE 106I",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950082054",
            "telephone_number": "408-568-6455",
            "fax_number": "888-706-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRA",
        "first_name": "BREENU",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-10",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC # 53160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.