NICOLE DIANE BRUNN
NPI 1972167351
Marriage & Family Therapist in San Jose, CA

Q: What is Nicole Brunn's NPI number?

The NPI number for Nicole Brunn is 1972167351. It was assigned to this individual provider in the NPPES registry on April 30, 2019.

Q: What is Nicole Brunn's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: Is Nicole Brunn enrolled in Medicare?

No. Nicole Brunn has opted out of Medicare through March 21, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Nicole Brunn was last updated on April 30, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since April 30, 2019Opted out of Medicare · through Mar 21, 2028

160 E VIRGINIA ST STE 100, SAN JOSE, CA 95112(408) 918-2618(408) 579-6131 Get Directions Write a Review

NPPES record last updated: April 30, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Nicole Diane Brunn NPPES

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

NICOLE DIANE BRUNN (NPI 1972167351) is an individual marriage & family therapist in San Jose, California and active in the NPI registry since April 2019. She has opted out of Medicare through March 21, 2028.

NPPES Registry Identity

NPI1972167351

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameNICOLE DIANE BRUNN

Location Address160 E VIRGINIA ST STE 100San Jose, CA 95112-5865

Mailing Address160 E Virginia St Ste 100San Jose, CA 95112-5865 · (408) 918-2618 · Fax (408) 579-6131

Phone(408) 918-2618

Fax(408) 579-6131

Sole ProprietorNo

Enumeration DateApril 30, 2019

✔ NPI 1972167351 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

Definition

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.

160 E VIRGINIA ST STE 100, San Jose, CA 95112

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Nicole Diane Brunn has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 21, 2024 through March 21, 2028.

Opt-Out Effective DateMarch 21, 2024

Opt-Out In Effect ThroughMarch 21, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

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

KATE LOUISE RUSSELL-BOGAN

Student in an Organized Health Care Education/Training Program