Kenneth Lee Brynjolfsson, ED.D.

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

License

PSY 3938 Issued in CA

Practice address

504 Turquoise CT
Redding, CA 96003-3343

Phone

(530) 604-4192

Fax

(530) 243-6247

NPI assigned

Apr 13, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447475710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 TURQUOISE CT",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960033343",
            "telephone_number": "530-604-4192",
            "fax_number": "530-243-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 TURQUOISE CT",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960033343",
            "telephone_number": "530-604-4192",
            "fax_number": "530-243-6247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYNJOLFSSON",
        "first_name": "KENNETH",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "CA",
            "license": "PSY 3938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Meredith Chiropractic, Inc.
• Cene Salsedo Bryant
• Kim Bennallack Bryant, LMFT
• Rhonda Lanette Bryels-Nechanicky, MFTI
• Ann Osullivan Brynjolfesson, LMFT
• Daniel William Buchanan
• Susan Bucher
• Tayonna Buck
• Christopher John Buckley, PA-C
• Jessica Buick, PHD

• Intellectual & Developmental Disabilities Psychologist in Redding, CA
• Providers in Redding, CA by specialty
• Intellectual & Developmental Disabilities Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.