OTIS NMN BROOME JR. (NPI# 1164077830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164077830 |
| Entity Type | Individual |
| Full Name | OTIS NMN BROOME JR. |
| Practice Address |
100 W Walnut St Ste 375 Pasadena CA 91124-0001 |
| Practice Telephone | 6263957100 |
| Mailing Telephone | 6263957100 |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2019-09-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers |
| Street Address |
100 W WALNUT ST STE 375 |
| City | PASADENA |
| State | CA |
| Zip Code | 91124-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598767642 | Paul Dante Jacoy | Chiropractor | 100 W Walnut St Ste 375, Pasadena, CA 91124-1220 | 2005-06-01 |
| 1760082770 | Haley A Land | Social Worker | 100 W Walnut St Ste 375, Pasadena, CA 91124-0001 | 2020-10-28 |
| 1043817406 | Christie Leung | Social Worker | 100 W Walnut St Ste 375, Pasadena, CA 91124-0001 | 2020-10-07 |
| 1710584784 | Ashley Fermin | Rehabilitation Practitioner | 100 W Walnut St Ste 375, Pasadena, CA 91124-0001 | 2020-10-02 |
| 1881291086 | Andrea M. Gonzalez | Marriage & Family Therapist | 100 W Walnut St Ste 375, Pasadena, CA 91124-0001 | 2020-10-01 |
| 1023625761 | Georgie Irene Rogers | Marriage & Family Therapist | 100 W Walnut St Ste 375, Pasadena, CA 91124-0001 | 2020-09-27 |
| 1548877640 | Sharon Patricia Martinez | Rehabilitation Practitioner | 100 W Walnut St Ste 375, Pasadena, CA 91124-0001 | 2020-09-23 |
| 1346857414 | Brittany Lauren Ramirez | Rehabilitation Practitioner | 100 W Walnut St Ste 375, Pasadena, CA 91124-0001 | 2020-09-23 |
| 1588279632 | D'andra Pearl Johnson | Marriage & Family Therapist | 100 W Walnut St Ste 375, Pasadena, CA 91124-0001 | 2020-09-14 |
| 1629683164 | Virginia Gonzalez Lopez | Rehabilitation Practitioner | 100 W Walnut St Ste 375, Pasadena, CA 91124-0001 | 2020-09-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629556964 | Elizabeth Ortiz | Marriage & Family Therapist | 100 W Walnut Streer, Pasadena, CA 91124 | 2018-07-30 |
| 1144755679 | Victoria Bates | Marriage & Family Therapist | 100 W Walnut St. Suite 375, Pasadena, CA 91124 | 2017-04-21 |
| 1295015287 | Jacqueline Zarate | Marriage & Family Therapist | 100 W Walnut St # 375, Pasadena, CA 91124 | 2011-08-22 |
| 1922475979 | Kelly K Choi | Social Worker | 100 W Walnut St # 375, Pasadena, CA 91124 | 2015-08-25 |
| 1770902751 | Araceli Gomez | Social Worker | 100 W Walnut St # 375, Pasadena, CA 91124 | 2014-04-07 |
| 1336791375 | Jianyin Li | Student in an Organized Health Care Education/Training Program | 100 W Wanut Street Suite 375, Pasadena, CA 91124-0001 | 2019-07-10 |
| 1851926588 | Alicia Lagos | Marriage & Family Therapist | 100 W Walnut St, Pasadena, CA 91124-0001 | 2020-03-03 |
| 1518590074 | Annie Rodas | Marriage & Family Therapist | 100 W Walnut St, Pasadena, CA 91124-0001 | 2020-02-12 |
| 1326695099 | Serena Garcia | Rehabilitation Practitioner | 100 W Walnut St # 375, Pasadena, CA 91124-0001 | 2019-08-19 |
| 1740835594 | Teresa Ruiz Lorenzo | Rehabilitation Practitioner | 100 W Walnut St # 375, Pasadena, CA 91124-0001 | 2019-08-08 |
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| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372153 | Donna Shanahan, Lmft | Marriage & Family Therapist | 595 E Colorado Blvd Ste 607, Pasadena, CA 91101-2015 | 2020-09-28 |
| 1568071298 | Brigit Jeffries | Marriage & Family Therapist | 426 S Los Robles Ave Apt E, Pasadena, CA 91101-3257 | 2020-07-29 |
| 1962028886 | Yuanzen Tung | Marriage & Family Therapist | 960 E Green St Ste 114, Pasadena, CA 91106-2401 | 2020-06-17 |
| 1780208801 | Ivy Zequeira | Marriage & Family Therapist | 130 S Euclid Ave Ste 2, Pasadena, CA 91101-2471 | 2020-06-04 |
| 1376167361 | Melba Rachel Mathew | Marriage & Family Therapist | 595 E Colorado Blvd Ste 211, Pasadena, CA 91101-2028 | 2020-06-04 |
| 1275156150 | Heidi Pidcoke | Marriage & Family Therapist | 696 S Madison Ave, Pasadena, CA 91106-3830 | 2020-05-26 |
| 1952924235 | Lilit Arvahi | Marriage & Family Therapist | 711 E Walnut St Ste 407, Pasadena, CA 91101-4403 | 2020-05-21 |
| 1730724022 | Patricia Carmalt | Marriage & Family Therapist | 97 W Bellevue Dr Ste 6, Pasadena, CA 91105-2501 | 2019-11-11 |
| 1457993339 | Lilit Melik-bakhshyan | Marriage & Family Therapist | 940 E Union St Ste 102, Pasadena, CA 91106-1780 | 2019-10-12 |
| 1295384022 | Jenny Berman | Marriage & Family Therapist | 745 S Marengo Ave Ste 108, Pasadena, CA 91106-4738 | 2019-09-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.