Individual provider Active NPI

Michelle Brown

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1952845208
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
120942 Issued in CA
Practice address
4062 Shasta St.
Apt 8
San Diego, CA 92109
Phone
(805) 229-1644
NPI assigned
Dec 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF89301 CA
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X 120942 CA Primary

Addresses

Primary practice location

4062 Shasta St.
Apt 8
San Diego, CA 92109

Mailing address

1804 Garnet Ave Ste 2022
San Diego, CA 92109-3352
Phone (559) 259-1677

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
120942CAMDMarriage & Family Therapist
IMF89301CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Interface Children and Family Services Past 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": "1480982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1952845208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 GARNET AVE STE 2022",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093352",
            "telephone_number": "559-259-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4062 SHASTA ST.",
            "address_2": "APT 8",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92109",
            "telephone_number": "805-229-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-06",
        "last_updated": "2023-10-03",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF89301",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "120942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.