Individual provider Active NPI

Brett Jones

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1528436730
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
31199 Issued in CA
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

Updated by the provider on Sep 30, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
31199CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.