Individual provider Active NPI

Lisa Braverman, MA, AMFT

  • Marriage & Family Therapist
  • San Francisco, CA
National Provider Identifier
1962041053
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
117033 Issued in CA
Practice address
1801 Vicente St
San Francisco, CA 94116-2923
Phone
(415) 681-3211
NPI assigned
Jan 6, 2020
Last updated
Feb 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 117033 CA
Marriage & Family Therapist 106H00000X CA
Marriage & Family Therapist 106H00000X 117033 CA Primary

Addresses

Primary practice location

1801 Vicente St
San Francisco, CA 94116-2923

Mailing address

1801 Vicente St
San Francisco, CA 94116-2923

Other practice location 1

204 Hampton Dr
Venice, CA 90291-8633
Phone (310) 396-6468

Other practice location 2

100 Masonic Ave
San Francisco, CA 94118-4415
Phone (415) 567-8370

Other practice location 3

1060 Howard St
San Francisco, CA 94103-2820
Phone (415) 252-4788

Other practice location 4

2261 Bryant St
San Francisco, CA 94110-2833
Phone (415) 748-7270

Other practice location 5

307 2nd Ave
San Mateo, CA 94401-3905
Phone (650) 405-7022

Other practice location 6

6323 Via Escondido Dr
Malibu, CA 90265-4484
Phone (855) 921-4973

Other identifiers 1

IdentifierTypeStateIssuer
1962041053MedicaidCA

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
117033CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1962041053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 VICENTE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 VICENTE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162923",
            "telephone_number": "415-681-3211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 Hampton Dr",
            "address_purpose": "LOCATION",
            "city": "Venice",
            "state": "CA",
            "postal_code": "902918633",
            "country_code": "US",
            "telephone_number": "310-396-6468",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Masonic Ave",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941184415",
            "country_code": "US",
            "telephone_number": "415-567-8370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1060 Howard St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941032820",
            "country_code": "US",
            "telephone_number": "415-252-4788",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2261 Bryant St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941102833",
            "country_code": "US",
            "telephone_number": "415-748-7270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "307 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "San Mateo",
            "state": "CA",
            "postal_code": "944013905",
            "country_code": "US",
            "telephone_number": "650-405-7022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6323 Via Escondido Dr",
            "address_purpose": "LOCATION",
            "city": "Malibu",
            "state": "CA",
            "postal_code": "902654484",
            "country_code": "US",
            "telephone_number": "855-921-4973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAVERMAN",
        "first_name": "LISA",
        "credential": "MA, AMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "117033",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "117033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962041053",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.