Active NPI
Brittney Ann Dewall
- Psychologist
- Temecula, CA
National Provider Identifier
1679980239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1-13-13564
- Practice address
- 28999 Old Town Front Street
Suite 203
Temecula, CA 92590 - Phone
- (858) 444-8823
- Fax
- (858) 444-8827
- NPI assigned
- Jul 16, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1-13-13564 | CA | Primary |
Addresses
Primary practice location
28999 Old Town Front Street
Suite 203
Temecula, CA 92590
Mailing address
10065 Old Grove Road
Suite 200
San Diego, CA 92131
Phone (858) 444-8823
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405468800000",
"number": "1679980239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10065 OLD GROVE ROAD",
"address_2": "SUITE 200",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92131",
"telephone_number": "858-444-8823",
"fax_number": "858-444-8827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28999 OLD TOWN FRONT STREET",
"address_2": "SUITE 203",
"city": "TEMECULA",
"state": "CA",
"postal_code": "92590",
"telephone_number": "858-444-8823",
"fax_number": "858-444-8827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEWALL",
"first_name": "BRITTNEY",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-16",
"last_updated": "2014-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "1-13-13564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temecula, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.