Individual provider Active NPI

Faith Brozovich, PH.D.

  • Clinical Psychologist
  • Menlo Park, CA
National Provider Identifier
1528498003
Registry record updated Nov 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
25186 Issued in CA
Practice address
845 El Camino Real
Menlo Park, CA 94025
Phone
(650) 906-5225
NPI assigned
Nov 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 25186 CA Primary

Addresses

Primary practice location

845 El Camino Real
Menlo Park, CA 94025

Mailing address

1600 Villa Street Apt 207
Mountain View, CA 94041
Phone (650) 906-5225

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
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1384819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384819200000",
    "number": "1528498003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 VILLA STREET APT 207",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "94041",
            "telephone_number": "650-906-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 EL CAMINO REAL",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "94025",
            "telephone_number": "650-906-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROZOVICH",
        "first_name": "FAITH",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-19",
        "last_updated": "2013-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "25186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; 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.