Brooke Nadine Davidson, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

31050 Issued in CA

Practice address

4700 Von Karman Ave Ste 102
Newport Beach, CA 92660-2194

Phone

(949) 743-1457

NPI assigned

Aug 17, 2014

Sex

Female

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Julia Evans PHD Psychology PCGroup PAC ID 0446510309, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Julia Evans PHD Psychology PC

  dba Brain Wellness Institute

  • Clinical Psychologist
  • Costa Mesa, CA
  • NPI 1861902280
  Medicare reassignment Care Compare group NPD
• Morrison Child and Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, OR
  • NPI 1346382975
  NPD (past)

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

{
    "created_epoch": "1408233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1538568407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 VON KARMAN AVE",
            "address_2": "STE 102",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602194",
            "telephone_number": "949-743-1457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 VON KARMAN AVE STE 102",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602194",
            "telephone_number": "949-743-1457"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11035 NE Sandy Blvd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972202553",
            "country_code": "US",
            "telephone_number": "503-258-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "BROOKE",
        "middle_name": "NADINE",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-17",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "31050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Porzio, M.D., Inc
• David R Reinstadler M.D. Inc
• David Wirta M D Inc
• Kathy David, REEG/EPT, CNIM
• Melanie S David, PSY.D.
• Steven Craig Davidson, PHD
• Brandy Davis
• Brenton Gregory Davis, MD
• David Mark Davis, MD
• Marilyn J Davis, PH.D

• Psychologist in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.