Individual provider Active NPI

Brandon Freiberg Heimberg, PSYD

  • Clinical Neuropsychologist
  • Calabasas, CA
National Provider Identifier
1205364635
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY33820 Issued in CA
Practice address
5000 Parkway Calabasas Ste 218
Calabasas, CA 91302-3909
Phone
(424) 234-1155
Fax
(855) 943-3312
NPI assigned
May 30, 2017
Last updated
Sep 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 0262737 NY
Clinical Neuropsychologist 103G00000X PSY33820 CA Primary
Clinical Psychologist 103TC0700X 0262737 NY
Clinical Psychologist 103TC0700X PSY33820 CA

Addresses

Primary practice location

5000 Parkway Calabasas Ste 218
Calabasas, CA 91302-3909

Mailing address

21300 Dumetz Rd Apt G
Woodland Hills, CA 91364-4409
Phone (646) 687-1004

Other practice location 1

125 Park Ave Fl 25
New York, NY 10017-5550
Phone (424) 234-1155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 2, 2023 through Jan 2, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY33820CAMDClinical Neuropsychologist
0262737NYMDClinical Neuropsychologist
33820CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Heimberg Neuropsychology - Psychological Testing Inc Clinical Neuropsychologist CurrentSince May 1, 2023 Accepting new patients

Locations

23632 Calabasas Rd
Ste 201
Calabasas, CA 91302
Phone (424) 209-4345

4766 Park Granada
Ste 202
Calabasas, CA 91302
Phone (805) 358-7996

5000 Parkway Calabasas
Ste 218
Calabasas, CA 91302
Phone (424) 234-1155

125 Park Ave
Fl 25
New York, NY 10017
Phone (201) 809-3000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1205364635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21300 DUMETZ RD APT G",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913644409",
            "telephone_number": "646-687-1004",
            "fax_number": "855-943-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 PARKWAY CALABASAS STE 218",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913023909",
            "telephone_number": "424-234-1155",
            "fax_number": "855-943-3312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Park Ave Fl 25",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100175550",
            "country_code": "US",
            "telephone_number": "424-234-1155",
            "fax_number": "855-943-3312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEIMBERG",
        "first_name": "BRANDON",
        "middle_name": "FREIBERG",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "0262737",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY33820",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "0262737",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY33820",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calabasas, CA

Sources for this page

Verify at the official NPI Registry.