Active NPI
Brett Jones
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1528436730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 31199
- Practice address
- 3665 Kearny Villa Rd Ste 400
San Diego, CA 92123-1955 - Phone
- (248) 410-0222
- NPI assigned
- Sep 3, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | 31199 | CA | Primary |
Addresses
Primary practice location
3665 Kearny Villa Rd Ste 400
San Diego, CA 92123-1955
Mailing address
3665 Kearny Villa Rd Ste 400
San Diego, CA 92123-1955
Phone (248) 410-0222
Other practice location 1
505 N Euclid St
Suite 300
Anaheim, CA 92801-5506
Phone (714) 871-5646
Other practice location 2
707 N Broadway
Baltimore, MD 21205
Phone (248) 410-0222
Other practice location 3
3665 Kearny Villa Rd Ste 400
San Diego, CA 92123-1955
Phone (248) 410-0222
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31199 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Youth Services | 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 and National Provider Directory roles.
-
- Adolescent and Children Mental Health Clinic/Center
- Anaheim, CA
- NPI 1770617987
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569801600000",
"number": "1528436730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3665 KEARNY VILLA RD STE 400",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231955",
"telephone_number": "248-410-0222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3665 KEARNY VILLA RD STE 400",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231955",
"telephone_number": "248-410-0222"
}
],
"practiceLocations": [
{
"address_1": "505 N Euclid St",
"address_2": "Suite 300",
"address_purpose": "LOCATION",
"city": "Anaheim",
"state": "CA",
"postal_code": "928015506",
"country_code": "US",
"telephone_number": "714-871-5646",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "707 N Broadway",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "21205",
"country_code": "US",
"telephone_number": "248-410-0222",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3665 Kearny Villa Rd Ste 400",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921231955",
"country_code": "US",
"telephone_number": "248-410-0222",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JONES",
"first_name": "BRETT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-03",
"last_updated": "2019-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "31199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.