Brian Buzzella, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

25059 Issued in CA

Practice address

4025 Camino del Rio S Ste 300
San Diego, CA 92108-4108

Phone

(619) 542-7745

NPI assigned

Jul 30, 2012

Sex

Male

Sole proprietor

Yes

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

Opted out of Medicare

Yes, effective Sep 26, 2020 through Sep 26, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• San Diego Center of Individual and Family Well-Being Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
  • NPI 1427683788
  NPD Authorized official

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1720334535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 CAMINO DEL RIO S STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084108",
            "telephone_number": "619-542-7745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 CAMINO DEL RIO S STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084108",
            "telephone_number": "619-542-7745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUZZELLA",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-30",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "25059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Renae Buxton
• Rebecca Edith Buza, OT
• Rachel Buzbee, LMFT
• Erin Buzon
• Tanya Buzzanga, CCC-SLP
• Frances Bychak
• Kenneth James Bychak, RN
• Kristina Byers-Spencer, MD
• Alexander Byers
• Steven J Byers, DDS

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.