Active NPI
Clifford Michael Brothers, PHD
- Marriage & Family Therapist
- San Jose, CA
National Provider Identifier
1700935160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT12129
- Practice address
- 1101 S Winchester Blvd
BLDG O Suite 284
San Jose, CA 95128 - Phone
- (408) 271-8558
- Fax
- (408) 248-8260
- NPI assigned
- Jan 8, 2007
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY7003 | CA | |
| Marriage & Family Therapist | 106H00000X | MFT12129 | CA | Primary |
Addresses
Primary practice location
1101 S Winchester Blvd
BLDG O Suite 284
San Jose, CA 95128
Mailing address
4079 Glenwood Drive
Scotts Valley, CA 95066
Phone (408) 271-8558
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100622000837 | CA | Practitioner - Clinical Psychologist | 1850437856 | Practice locations: Oceanside, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1979
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
5105 Teal Way
Oceanside, CA 92057-1844
Phone (408) 271-5885
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY7003 | CA | MD | Clinical Psychologist |
| MFT12129 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1700935160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4079 GLENWOOD DRIVE",
"city": "SCOTTS VALLEY",
"state": "CA",
"postal_code": "95066",
"telephone_number": "408-271-8558",
"fax_number": "408-248-8250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 S WINCHESTER BLVD",
"address_2": "BLDG O SUITE 284",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95128",
"telephone_number": "408-271-8558",
"fax_number": "408-248-8260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROTHERS",
"first_name": "CLIFFORD",
"middle_name": "MICHAEL",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY7003",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFT12129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.