Robert Arthur Broenen, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY13147 Issued in CA

Practice address

161 Avenida Cabrillo
San Clemente, CA 92672-4040

Phone

(949) 542-9052

Fax

(949) 542-3280

NPI assigned

Feb 12, 2007

Last updated

Mar 7, 2012By the provider in NPPES

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1144362914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 AVENIDA CABRILLO",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724040",
            "telephone_number": "949-542-9052",
            "fax_number": "949-542-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 AVENIDA CABRILLO",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724040",
            "telephone_number": "949-542-9052",
            "fax_number": "949-542-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROENEN",
        "first_name": "ROBERT",
        "middle_name": "ARTHUR",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST",
            "identifier": "OPL13147",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn Carol Briganti, RN, NP, APRN,BC
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• Megan Brooks, CCC-SLP
• Greg A Brown, M.D.
• Nancy Krehbiel Brownell, MD
• William Jackson Brownson, D.D.S.
• Deborah Laura Brownstone, M.D.

• Clinical Psychologist in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; 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.