Individual provider Active NPI

Brittany Bostick

  • Marriage & Family Therapist
  • South Pasadena, CA
National Provider Identifier
1932785094
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
146411 Issued in CA
Practice address
205 Pasadena Ave
South Pasadena, CA 91030-2919
Phone
(323) 344-5536
NPI assigned
Mar 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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 146411 CA Primary

Addresses

Primary practice location

205 Pasadena Ave
South Pasadena, CA 91030-2919

Mailing address

205 Pasadena Ave
South Pasadena, CA 91030-2919
Phone (323) 344-5536

Other practice location 1

1149 W 190th St Ste 2200
Gardena, CA 90248-4344
Phone (310) 856-0800

Other identifiers 4

IdentifierTypeStateIssuer
7708OtherCAMEDICAL
7667OtherCAMEDICAL
7184OtherCAMEDICAL
7368OtherCAMEDICAL

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
146411CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for the Redesign of Learning Marriage & Family Therapist PastSince Jan 15, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1932785094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 PASADENA AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910302919",
            "telephone_number": "323-344-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PASADENA AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910302919",
            "telephone_number": "323-344-5536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1149 W 190th St Ste 2200",
            "address_purpose": "LOCATION",
            "city": "Gardena",
            "state": "CA",
            "postal_code": "902484344",
            "country_code": "US",
            "telephone_number": "310-856-0800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSTICK",
        "first_name": "BRITTANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-19",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "146411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "7708",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "7667",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "7184",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "7368",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.

Verify at the official NPI Registry.