Individual provider Active NPI

Alan Edward Brooker, PH.D., ABPP-CN

  • Clinical Neuropsychologist
  • Sacramento, CA
National Provider Identifier
1487979753
Registry record updated Apr 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY9414 Issued in CA
Practice address
2609 Capitol Ave
Suite #2
Sacramento, CA 95816-5904
Phone
(916) 446-6519
Fax
(916) 448-2559
NPI assigned
Mar 30, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY9414 CA Primary
Forensic Psychologist 103TF0200X PSY9414 CA

Addresses

Primary practice location

2609 Capitol Ave
Suite #2
Sacramento, CA 95816-5904

Mailing address

2609 Capitol Ave
Suite #2
Sacramento, CA 95816-5904
Phone (916) 446-6519

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
PSY9414CAMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302825600000",
    "number": "1487979753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 CAPITOL AVE",
            "address_2": "SUITE #2",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165904",
            "telephone_number": "916-446-6519",
            "fax_number": "916-448-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 CAPITOL AVE",
            "address_2": "SUITE #2",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165904",
            "telephone_number": "916-446-6519",
            "fax_number": "916-448-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKER",
        "first_name": "ALAN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PH.D., ABPP-CN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-30",
        "last_updated": "2011-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY9414",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY9414",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2011; 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.