Individual provider Active NPI

Robert L Bray, PHD

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1154491363
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 10054 Issued in CA
Practice address
5959 Mission Gorge Rd
Suite 106
San Diego, CA 92120-4017
Phone
(619) 283-1116
Fax
(619) 283-1131
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS 10054 CA Primary

Addresses

Primary practice location

5959 Mission Gorge Rd
Suite 106
San Diego, CA 92120-4017

Mailing address

5959 Mission Gorge Rd
Suite 106
San Diego, CA 92120-4017
Phone (619) 283-1116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120201000832 CA Practitioner - Clinical Social Worker 7113184268 Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5959 Mission Gorge Rd
Suite 106
San Diego, CA 92120-4019
Phone (619) 283-1116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
10054CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alderman and Marshall Inc. Clinical PastSince Dec 27, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154491363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 MISSION GORGE RD",
            "address_2": "SUITE 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204017",
            "telephone_number": "619-283-1116",
            "fax_number": "619-283-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 MISSION GORGE RD",
            "address_2": "SUITE 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204017",
            "telephone_number": "619-283-1116",
            "fax_number": "619-283-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 10054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.