Organization Active NPI

Quetzalli Zephyr, Inc.

  • Clinical Neuropsychologist
  • Brookline, MA
National Provider Identifier
1104570019
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
QUETZALLI ZEPHYR, INC.
Practice address
126 Harvard St FL 3
Brookline, MA 02446-6426
Phone
(617) 388-9306
NPI assigned
Feb 9, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Authorized official

Name
Dr. Jessica Boyatt, PSYDNPI 1245311885
Title
Owner/President
Phone
(617) 388-9306

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X

Addresses

Primary practice location

126 Harvard St FL 3
Brookline, MA 02446-6426

Mailing address

3 Traymore St
Cambridge, MA 02140-2213
Phone (617) 388-9306

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jboyatt@lifeshots.com

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644364800000",
    "number": "1104570019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 TRAYMORE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021402213",
            "telephone_number": "617-388-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 HARVARD ST FL 3",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024466426",
            "telephone_number": "617-388-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUETZALLI ZEPHYR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A",
        "authorized_official_last_name": "BOYATT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "617-388-9306",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jboyatt@lifeshots.com",
            "affiliation": "N",
            "address_1": "126 Harvard St Fl 3",
            "city": "Brookline",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024466426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.