Andie Jo Brunk, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

152566 Issued in CA

Practice address

1722 S Lewis Rd
Camarillo, CA 93012-8520

Phone

(805) 366-4205

NPI assigned

May 19, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Medens Health

  • Clinical Psychologist
  • San Francisco, CA
  • NPI 1003431784

  Marriage & Family Therapist

  NPD

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1871284711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5479 CAMINO COMPADRE",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930128624",
            "telephone_number": "805-340-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 S LEWIS RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930128520",
            "telephone_number": "805-366-4205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "223 E Thousand Oaks Blvd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Thousand Oaks",
            "state": "CA",
            "postal_code": "913607706",
            "country_code": "US",
            "telephone_number": "818-473-5656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9713 Santa Monica Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902104236",
            "country_code": "US",
            "telephone_number": "818-473-5656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNK",
        "first_name": "ANDIE",
        "middle_name": "JO",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-19",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "13476",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "152566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Brooks
• Brittany Broussard
• Matthew Brown, RBT
• Melodie Lynnette Brown
• Shentina A Brown
• Leesha Brunson
• Susan Bryan
• Janelle Buchanan
• Patrick Dennis Buchanan, M.D.
• Celes Elizabeth Buck, MICROPIGMENTATION

• Marriage & Family Therapist in Camarillo, CA
• Providers in Camarillo, 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 Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.