Jeffrey Ian Bragman, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY5659 Issued in CA

Practice address

974 Ralston Ave
Suite 10
Belmont, CA 94002-2252

Phone

(800) 353-2761

Fax

(650) 591-4773

NPI assigned

Dec 15, 2005

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841276599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 CEDAR ST",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702163",
            "telephone_number": "650-591-4331",
            "fax_number": "650-591-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "974 RALSTON AVE",
            "address_2": "SUITE 10",
            "city": "BELMONT",
            "state": "CA",
            "postal_code": "940022252",
            "telephone_number": "800-353-2761",
            "fax_number": "650-591-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAGMAN",
        "first_name": "JEFFREY",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY5659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Belmont, CA
• Providers in Belmont, CA by specialty
• 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.