Jacquelyn Brown, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY23315 Issued in CA

Practice address

1662 Plum LN Ste 102
Redlands, CA 92374-4595

Phone

(909) 348-3580

Fax

(909) 425-6635

NPI assigned

Mar 16, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1821122052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1662 PLUM LN STE 102",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744595",
            "telephone_number": "909-348-3580",
            "fax_number": "909-425-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1662 PLUM LN STE 102",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744595",
            "telephone_number": "909-348-3580",
            "fax_number": "909-425-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JACQUELYN",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY23315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dale Broome, M.D.
• Taylor Broughton, PSYD
• Allan Wilton Brown, PHD
• Candace Brown, LIC. MARRIAGE & FAMI
• Hallie Renee McCormick Brown
• Kathleen M Brown, C-FNP
• Roger C Brown, DDS
• Shawna Michele Brown, LMFT
• Trina Brown, SLP
• Maria Bruce, RN

• Clinical Psychologist in Redlands, CA
• Providers in Redlands, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.