Active NPI
Jennifer Marie Bruha, MACP, MAP
- Case Management Agency
- San Mateo, CA
National Provider Identifier
1992935506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Agency
- Practice address
- 3521 Casanova Dr
San Mateo, CA 94403-2908 - Phone
- (650) 574-4562
- NPI assigned
- Jul 16, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | Primary | ||
| Community/Behavioral Health Agency | 251S00000X |
Addresses
Primary practice location
3521 Casanova Dr
San Mateo, CA 94403-2908
Mailing address
3521 Casanova Dr
San Mateo, CA 94403-2908
Phone (650) 574-4562
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2022 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29015 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247702400000",
"number": "1992935506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3521 CASANOVA DR",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944032908",
"telephone_number": "650-574-4562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3521 CASANOVA DR",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944032908",
"telephone_number": "650-574-4562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUHA",
"first_name": "JENNIFER",
"middle_name": "MARIE",
"credential": "MACP, MAP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-16",
"last_updated": "2009-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": true
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.