Kimberly Brooks, PSYD

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

License

PSY34339 Issued in CA

Practice address

525 Cabrillo Park Dr Ste 105
Santa Ana, CA 92701-5017

Phone

(714) 617-4616

Fax

(714) 617-4508

NPI assigned

Dec 23, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kimberly Brooks Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Innovative Psychological Services, Inc

  • Forensic Psychologist
  • North Charleston, SC
  • NPI 1861263204
  NPD Authorized official
• Pasadena Clinical Group, a Psychology Corporation

  • Psychologist
  • Pasadena, CA
  • NPI 1790213247
  NPD (past)

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

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705190400000",
    "number": "1770948432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 CABRILLO PARK DR STE 105",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927015017",
            "telephone_number": "714-617-4616",
            "fax_number": "714-617-4508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 CABRILLO PARK DR STE 105",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927015017",
            "telephone_number": "714-617-4616",
            "fax_number": "714-617-4508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "KIMBERLY",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-23",
        "last_updated": "2024-01-14",
        "certification_date": "2024-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY34339",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY34339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "BROOKS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dallas C. Broge, BEHAVIOR TECHNICIAN
• Jessica A. Brommelhoff, PH.D.
• Dina Bronshteyn
• Cheryl Brooks
• Earl Brooks IV
• Laural Lyn Brooks, P.T.
• Rhylee Nicole Brooks
• Valerie Kay Brooks, REGISTERED NURSE
• Cory Brosch, LMFT
• Zoe Broussard

• Forensic Psychologist in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Forensic Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2024; 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.