Active NPI
Brett Donnelly
- Clinical Psychologist
- Isla Vista, CA
National Provider Identifier
1407258080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 26685
- Practice address
- 6586 Picasso Rd
Isla Vista, CA 93117-4651 - Phone
- (805) 699-6668
- NPI assigned
- Sep 25, 2014
- Last updated
- Sep 25, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 | 26685 | CA | Primary |
Addresses
Primary practice location
6586 Picasso Rd
Isla Vista, CA 93117-4651
Mailing address
PO Box 30910
Santa Barbara, CA 93130-0910
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acacia Counseling & Wellness | Clinical | Past | Accepting new patients |
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.
-
- Clinical Psychologist
- Isla Vista, CA
- NPI 1003218942
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411603200000",
"number": "1407258080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30910",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931300910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6586 PICASSO RD",
"city": "ISLA VISTA",
"state": "CA",
"postal_code": "931174651",
"telephone_number": "805-699-6668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONNELLY",
"first_name": "BRETT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-09-25",
"last_updated": "2014-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "26685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Isla Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.