Vanessa Diane Isetta, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY20941 Issued in CA

Practice address

2309 Pacific Coast Hwy
Suite #207
Hermosa Beach, CA 90254-2751

Phone

(310) 980-7352

NPI assigned

Apr 24, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ms. Vanessa Diane Brusavich Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Isetta Psychotherapy, Inc.

  • Health Service Clinic/Center
  • Hermosa Beach, CA
  • NPI 1114671161
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1003035452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 PACIFIC COAST HWY STE 207",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542753",
            "telephone_number": "310-980-7352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 PACIFIC COAST HWY",
            "address_2": "SUITE #207",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542751",
            "telephone_number": "310-980-7352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISETTA",
        "first_name": "VANESSA",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00007302",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA DMH PROVIDER",
            "identifier": "CB24537",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANESSA",
            "last_name": "BRUSAVICH",
            "middle_name": "DIANE",
            "prefix": "MS.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Isetta Psychotherapy, Inc.
• Rebecca Ivanusich
• Alevtyna Izaak, REGISTERED NURSE BSN
• J M Pearson, MD, Inc
• J Shah Orthopaedics Inc
• Kristina Jackson, MFT

• Clinical Psychologist in Hermosa Beach, CA
• Providers in Hermosa Beach, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.