Individual provider Active NPI

Gail F. Brenner, PH.D.

  • Psychologist
  • Santa Barbara, CA
National Provider Identifier
1376690404
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY12577 Issued in CA
Practice address
22 W Micheltorena St
Suite B
Santa Barbara, CA 93101-6522
Phone
(805) 570-9765
Fax
(805) 963-4922
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY12577 CA Primary

Addresses

Primary practice location

22 W Micheltorena St
Suite B
Santa Barbara, CA 93101-6522

Mailing address

PO Box 90658
Santa Barbara, CA 93190-0658
Phone (805) 570-9765

Other identifiers 1

IdentifierTypeStateIssuer
PSY125770MedicaidCA

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY12577CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1376690404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90658",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931900658",
            "telephone_number": "805-570-9765",
            "fax_number": "805-963-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 W MICHELTORENA ST",
            "address_2": "SUITE B",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931016522",
            "telephone_number": "805-570-9765",
            "fax_number": "805-963-4922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNER",
        "first_name": "GAIL",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY12577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY125770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.