Active NPI
Bryan R McNutt, PH.D, LMFT
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1699077206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY28897
- Practice address
- 2214 5TH Ave
San Diego, CA 92101-2104 - Phone
- (619) 540-6560
- NPI assigned
- Dec 2, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC52348 | CA | |
| Clinical Psychologist | 103TC0700X | PSY28897 | CA | Primary |
Addresses
Primary practice location
2214 5TH Ave
San Diego, CA 92101-2104
Mailing address
2214 5TH Ave
San Diego, CA 92101-2104
Phone (619) 540-6560
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28897 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| PSY28897 | CA | MD | Clinical Psychologist |
| MFC52348 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483228800000",
"number": "1699077206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2214 5TH AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921012104",
"telephone_number": "619-540-6560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2214 5TH AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921012104",
"telephone_number": "619-540-6560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCNUTT",
"first_name": "BRYAN",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PH.D, LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-12-02",
"last_updated": "2017-01-01",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC52348",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY28897",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.