1. Home
  2. Directory
  3. NPI Profile

JUSTIN TYLER BROUSSARD
NPI 1326310632
Counselor - Mental Health in San Louis Obispo, CA

Active since February 01, 2012
3765 S. HIGUERA, SUITE 100, SAN LOUIS OBISPO, CA 93401(805) 781-3535(805) 503-6499 Get Directions Write a Review

NPPES record last updated: January 27, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Justin Tyler Broussard NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUSTIN TYLER BROUSSARD (NPI 1326310632) is an individual mental health provider in San Louis Obispo, California and active in the NPI registry since February 2012.

NPPES Registry Identity

NPI1326310632
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameJUSTIN TYLER BROUSSARD
Location Address3765 S. HIGUERA, SUITE 100San Louis Obispo, CA 93401
Mailing Address1750 Prefumo Canyon RdSan Louis Obispo, CA 93405 · (805) 781-3535 · Fax (805) 503-6499
Phone(805) 781-3535
Fax(805) 503-6499
Sole ProprietorYes
Enumeration DateFebruary 1, 2012
Last NPPES UpdateJanuary 27, 2014
✔ NPI 1326310632 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
3765 S. HIGUERA, San Louis Obispo, CA 93401
Open in Google Maps ↗

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRIANNA BIBERSTON
Counselor (Addiction (Substance Use Disorder))
3765 S. HIGUERA, SUITE 100
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 781-3535
TERENCE MICHAEL DEVER
Student in an Organized Health Care Education/Training Program
3765 S. HIGUERA, SUITE 100
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 781-3535
MEAGAN ELIZABETH KIRSCH
Marriage & Family Therapist
3765 S. HIGUERA, SUITE 100
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 781-3535

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justin Broussard's NPI number?

The NPI number for Justin Broussard is 1326310632. It was assigned to this individual provider in the NPPES registry on February 1, 2012.

Where is Justin Broussard located?

Justin Broussard practices at 3765 S. Higuera Suite 100, San Louis Obispo, CA 93401. The listed phone number is (805) 781-3535.

What is Justin Broussard's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Justin Broussard was last updated on January 27, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.