Brent Nelson Carter, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY8167 Issued in CA

Practice address

1320 Standiford Ave
Modesto, CA 95350-0726

Phone

(209) 557-1177

Fax

(209) 557-1083

NPI assigned

Dec 6, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700945748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 STANDIFORD AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500726",
            "telephone_number": "209-557-1177",
            "fax_number": "209-557-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 STANDIFORD AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500726",
            "telephone_number": "209-557-1177",
            "fax_number": "209-557-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "BRENT",
        "middle_name": "NELSON",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY8167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wallace B Carroll, MD
• Leanna Kristen Carrott
• Kristi Abigail Carson, C.M.T.
• Erick Cartaya Aguilar, NP
• Alexandra Carter
• Courtney Carter, SLP
• Donnie Carter Jr.
• Kristen Lynn Carter, M.A.
• Pamela Carter, DPT
• Tamika Mozina Carter, D.O.

• All providers in Modesto, CA
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.