Joelle I. Broffman, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

30413 Issued in CA

Practice address

2400 Grant Rd FL 2
Mountain View, CA 94040-4301

Phone

(408) 866-3802

NPI assigned

Jul 15, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 31, 2025 through Jan 31, 2027

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.

• Haven Cognitive Care, a Psychological Corporation

  • Clinical Neuropsychologist
  • Los Altos, CA
  • NPI 1699531814
  NPD Authorized official

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1023660552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 GRANT RD FL 2",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940404301",
            "telephone_number": "408-866-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 GRANT RD FL 2",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940404301",
            "telephone_number": "408-866-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROFFMAN",
        "first_name": "JOELLE",
        "middle_name": "I.",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "30413",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "30413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Briskin, NP
• Heather Elaine Bristol, P.A.-C, ATC
• Romualdas Brizgys, M.D.
• Nicole Rae Broadwell, FNP-BC
• Manisha Brodie
• Laura M Bromage, RN, NP
• Robert Bronstone, M.D.
• Brandon Brooks, DC
• Philip Brosterhous, MD
• Beth Robin Browdy, O.D.

• Clinical Psychologist in Mountain View, CA
• Providers in Mountain View, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.