Bryan Geoffrey Anderson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

75821 Issued in CA

Practice address

1247 7TH St Ste 202
Santa Monica, CA 90401-1643

Phone

(310) 562-5258

NPI assigned

Jun 15, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Grab the Wheel Kids

  • Adolescent and Children Mental Health Clinic/Center
  • Long Beach, CA
  • NPI 1114495801
  NPD (past) Authorized official

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1902336498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 WESTRIDGE RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900491229",
            "telephone_number": "310-562-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1247 7TH ST STE 202",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011643",
            "telephone_number": "310-562-5258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10780 Santa Monica Blvd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900257613",
            "country_code": "US",
            "telephone_number": "310-562-5258",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2300 Westridge Rd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900491229",
            "country_code": "US",
            "telephone_number": "310-562-5258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BRYAN",
        "middle_name": "GEOFFREY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "75821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachelle Daun Ancona, PHARMD
• Alyssa Rose Andersen, DPT
• Michael Allan Andersen, D.P.T.
• Wesley Allen Andersen, R.PH.
• Anderson and Palla Dental Partnership
• Julie Anderson
• Lauren Elizabeth Anderson
• Lorraine Anderson, MD
• Michael Anderson
• Michela Leslie Anderson, MSW.LCSW

• Clinical Social Worker in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.