Healthcare Provider Details

I. General information

NPI: 1619884996
Provider Name (Legal Business Name): JESSICA ADELINE BRACHA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2382 FARADAY AVE STE 200
CARLSBAD CA
92008-7220
US

IV. Provider business mailing address

31755 RANCHO AMIGOS RD
BONSALL CA
92003-5708
US

V. Phone/Fax

Practice location:
  • Phone: 949-922-1007
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number131476
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: