Active NPI
Nancy N. Brothers, PH.D.
- Psychologist
- Idyllwild, CA
National Provider Identifier
1700879301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY12284
- Practice address
- 54295 Village Center Dr
Suite 104
Idyllwild, CA 92549-2435 - Phone
- (951) 659-2207
- Fax
- (951) 659-2246
- NPI assigned
- Aug 30, 2005
- 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 | PSY12284 | CA | Primary |
Addresses
Primary practice location
54295 Village Center Dr
Suite 104
Idyllwild, CA 92549-2435
Mailing address
PO Box 2435
Idyllwild, CA 92549-2435
Phone (951) 659-2207
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273795200000",
"number": "1700879301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2435",
"city": "IDYLLWILD",
"state": "CA",
"postal_code": "925492435",
"telephone_number": "951-659-2207",
"fax_number": "951-659-2246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54295 VILLAGE CENTER DR",
"address_2": "SUITE 104",
"city": "IDYLLWILD",
"state": "CA",
"postal_code": "925492435",
"telephone_number": "951-659-2207",
"fax_number": "951-659-2246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROTHERS",
"first_name": "NANCY",
"middle_name": "N.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-08-30",
"last_updated": "2010-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY12284",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Idyllwild, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.