William Kent Brokken, M.D.

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

C33750 Issued in CA

Practice address

4433 Meadowlark LN
Santa Barbara, CA 93105

Phone

(805) 886-8021

Fax

(805) 687-1482

NPI assigned

Aug 2, 2005

Last updated

Dec 28, 2023By 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Luminous Dermatology

  • Dermatology Physician
  • Santa Barbara, CA
  • NPI 1609209576
  NPD

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1336140284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4433 MEADOWLARK LN",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "93105",
            "telephone_number": "805-886-8021",
            "fax_number": "805-687-1482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4433 MEADOWLARK LN",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "93105",
            "telephone_number": "805-886-8021",
            "fax_number": "805-687-1482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROKKEN",
        "first_name": "WILLIAM",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "C33750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATION NPI",
            "identifier": "1043211907",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D0584671",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rose Marie Bristol
• Zoe Bristol, M.A., CFY-SLP
• James L. Broderick, PH.D.
• Janness Marie Broderick, LCSW
• Katelynn Brodigan, NP, RN
• Ronald Brian Brooks, PH.D.
• David Garret Brosky
• Ryan Joseph Broumand
• Alicia Kenly Brown, PA-C
• Andrew Brown

• Dermatopathology Physician in Santa Barbara, CA
• Providers in Santa Barbara, CA by specialty
• Dermatopathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.