Active NPI
Kimberly L Brodsky, PHD
- Clinical Psychologist
- Berkeley, CA
National Provider Identifier
1225361306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 22956
- Practice address
- 1635 Josephine St
Berkeley, CA 94703-1320 - Phone
- (720) 530-9622
- NPI assigned
- Sep 8, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 22956 | CA | Primary |
Addresses
Primary practice location
1635 Josephine St
Berkeley, CA 94703-1320
Mailing address
1635 Josephine St
Berkeley, CA 94703-1320
Phone (720) 530-9622
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252368000000",
"number": "1225361306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1635 JOSEPHINE ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947031320",
"telephone_number": "720-530-9622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1635 JOSEPHINE ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947031320",
"telephone_number": "720-530-9622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODSKY",
"first_name": "KIMBERLY",
"middle_name": "L",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-08",
"last_updated": "2009-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "22956",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, 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.