Individual provider Active NPI

Jane Bryson, PH.D.

  • Psychologist
  • Santa Monica, CA
National Provider Identifier
1285954727
Registry record updated Jun 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY8748 Issued in CA
Practice address
3201 Wilshire Blvd
Suite 209
Santa Monica, CA 90403-2344
Phone
(310) 570-2509
Fax
(800) 313-7756
NPI assigned
Jun 7, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY8748 CA Primary

Addresses

Primary practice location

3201 Wilshire Blvd
Suite 209
Santa Monica, CA 90403-2344

Mailing address

PO Box 5413
Santa Monica, CA 90409-5413
Phone (310) 570-2509

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
I20110620000402 CA Practitioner - Clinical Psychologist 4486832581 Practice locations: Santa Monica, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3201 Wilshire Blvd
Suite 209
Santa Monica, CA 90403-2344
Phone (310) 570-2509

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY8748CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1275868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275868800000",
    "number": "1285954727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5413",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904095413",
            "telephone_number": "310-570-2509",
            "fax_number": "800-313-7756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 WILSHIRE BLVD",
            "address_2": "SUITE 209",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904032344",
            "telephone_number": "310-570-2509",
            "fax_number": "800-313-7756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYSON",
        "first_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-07",
        "last_updated": "2010-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY8748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.