Active NPI
Matthew Robert Brady, PSY.D.
- School Psychologist
- Westminster, CA
National Provider Identifier
1679716229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 081039000
- Practice address
- 13751 Milton Ave Apt C
Westminster, CA 92683-2928 - Phone
- (714) 330-4805
- Fax
- (714) 622-5668
- NPI assigned
- Apr 13, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | PSB 34205 | CA | |
| School Psychologist | 103TS0200X | 081039000 | CA | Primary |
Addresses
Primary practice location
13751 Milton Ave Apt C
Westminster, CA 92683-2928
Mailing address
13751 Milton Ave Apt C
Westminster, CA 92683-2928
Phone (714) 330-4805
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSB 34205 | CA | MD | Cognitive & Behavioral Psychologist |
| 081039000 | CA | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239580800000",
"number": "1679716229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13751 MILTON AVE APT C",
"city": "WESTMINSTER",
"state": "CA",
"postal_code": "926832928",
"telephone_number": "714-330-4805",
"fax_number": "714-622-5668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13751 MILTON AVE APT C",
"city": "WESTMINSTER",
"state": "CA",
"postal_code": "926832928",
"telephone_number": "714-330-4805",
"fax_number": "714-622-5668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADY",
"first_name": "MATTHEW",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-13",
"last_updated": "2009-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "CA",
"license": "PSB 34205",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "CA",
"license": "081039000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westminster, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.