Active NPI
James L. Broderick, PH.D.
- Psychologist
- Santa Barbara, CA
National Provider Identifier
1073663183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY5668
- Practice address
- 735 State St Ste 203
Santa Barbara, CA 93101-5502 - Phone
- (805) 708-3020
- NPI assigned
- Jan 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY5668 | CA | Primary |
Addresses
Primary practice location
735 State St Ste 203
Santa Barbara, CA 93101-5502
Mailing address
1206 Calle Gato
Santa Barbara, CA 93101
Phone (805) 898-1276
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY5668 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252368000000",
"number": "1073663183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1206 CALLE GATO",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "93101",
"telephone_number": "805-898-1276",
"fax_number": "805-708-3020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "735 STATE ST STE 203",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931015502",
"telephone_number": "805-708-3020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODERICK",
"first_name": "JAMES",
"middle_name": "L.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2009-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY5668",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Barbara, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.