Active NPI
Nathan Brandon
- Clinical Psychologist
- Jacksonville, FL
National Provider Identifier
1427494707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY29515
- Practice address
- 1606 Mayfair Rd Unit 301
Jacksonville, FL 32207-2363 - Phone
- (415) 993-2226
- NPI assigned
- May 14, 2013
- 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 | PSY29515 | CA | Primary |
Addresses
Primary practice location
1606 Mayfair Rd Unit 301
Jacksonville, FL 32207-2363
Mailing address
1606 Mayfair Rd Unit 301
Jacksonville, FL 32207-2363
Phone (415) 993-2226
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY29515 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721952000000",
"number": "1427494707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1606 MAYFAIR RD UNIT 301",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322072363",
"telephone_number": "415-993-2226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1606 MAYFAIR RD UNIT 301",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322072363",
"telephone_number": "415-993-2226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANDON",
"first_name": "NATHAN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-14",
"last_updated": "2024-07-26",
"certification_date": "2024-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY29515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.