Individual provider Active NPI

Sopagna Eap-Braje, PHD

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1639380215
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY29743 Issued in CA
Practice address
5405 Morehouse Dr Ste 330
San Diego, CA 92121-4786
Phone
(858) 215-1588
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PSY29743 CA Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

5405 Morehouse Dr Ste 330
San Diego, CA 92121-4786

Mailing address

5405 Morehouse Dr Ste 330
San Diego, CA 92121-4786
Phone (858) 215-1588

Other names 1

  • Sopagna Braje Professional name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220207001294 CA Practitioner - Clinical Psychologist 7113310566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern California Psychology Centers ApcGroup PAC ID 6406170653, 23 clinicians

Practice addresses (Care Compare)

8775 Aero Dr
Suite 238
San Diego, CA 92123-1756
Phone (619) 930-9524

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY29743CAMDClinical Psychologist
29743CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Parallel Learning Psychology P.C. Mental Health Current Accepting new patients
Southern California Psychology Centers, Apc Multi-Specialty CurrentSince Jan 1, 2022 Accepting new patients

Locations

8775 Aero Dr
San Diego, CA 92123
Phone (858) 565-4148

8775 Aero Dr
Ste 238
San Diego, CA 92123
Phone (619) 930-9524

Organizations & group practices 2

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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1639380215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 MOREHOUSE DR STE 330",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214786",
            "telephone_number": "858-215-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 MOREHOUSE DR STE 330",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214786",
            "telephone_number": "858-215-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAP-BRAJE",
        "first_name": "SOPAGNA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2022-02-09",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY29743",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOPAGNA",
            "last_name": "BRAJE",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.