Individual provider Active NPI

Virdette L Brumm, PHD

  • Clinical Child & Adolescent Psychologist
  • Monterey, CA
National Provider Identifier
1669565990
Registry record updated Jul 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PSY15531 Issued in CA
Practice address
787 Munras Ave
Suite 101
Monterey, CA 93940-3128
Phone
(831) 642-9400
Fax
(831) 645-7906
NPI assigned
Sep 30, 2006
Last updated
Jul 27, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PSY15531 CA Primary

Addresses

Primary practice location

787 Munras Ave
Suite 101
Monterey, CA 93940-3128

Mailing address

PO Box 3534
Carmel, CA 93921-3534
Phone (831) 642-9400

Other identifiers 1

IdentifierTypeStateIssuer
PSY155310MedicaidCA

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
I20090928000475 CA Practitioner - Clinical Psychologist 4880740190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

23625 Holman Hwy
Monterey, CA 93940-5902
Phone (831) 624-5311

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY15531CAMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital of the Monterey Peninsula CurrentSince Feb 7, 2011 Accepting new patients
Community Hospital of the Monterey Peninsula CurrentSince Feb 7, 2011 Accepting new patients
Central Coast Language and Learning Center Past Accepting new patients

Locations

23625 Wr Holman Hwy
Monterey, CA 93940
Phone (831) 622-2708

576 Hartnell St
Monterey, CA 93940
Phone (831) 625-4600

576 Hartnell St
Ste 300
Monterey, CA 93940
Phone (831) 625-4600

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248652800000",
    "number": "1669565990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3534",
            "city": "CARMEL",
            "state": "CA",
            "postal_code": "939213534",
            "telephone_number": "831-642-9400",
            "fax_number": "831-645-7906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "787 MUNRAS AVE",
            "address_2": "SUITE 101",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939403128",
            "telephone_number": "831-642-9400",
            "fax_number": "831-645-7906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMM",
        "first_name": "VIRDETTE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-30",
        "last_updated": "2009-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY15531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY155310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

Verify at the official NPI Registry.