Individual provider Active NPI

Brooke Anne Welch

  • Clinical Psychologist
  • San Francisco, CA
National Provider Identifier
1962848986
Registry record updated Nov 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
27866 Issued in CA
Practice address
1001 Potrero Ave
San Francisco, CA 94110-3518
Phone
(510) 647-8436
NPI assigned
May 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 27866 CA Primary

Addresses

Primary practice location

1001 Potrero Ave
San Francisco, CA 94110-3518

Mailing address

1001 Potrero Ave
San Francisco, CA 94110-3518

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160927002875 CA Practitioner - Clinical Psychologist 8820385321 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27866CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
City & County of San Francisco CurrentSince May 15, 2017 Accepting new patients
City and County of San Francisco CurrentSince May 15, 2017 Accepting new patients
University of California SFGH Medical Group CurrentSince Jul 30, 2016 Accepting new patients
City & County of San Francisco Current Accepting new patients
University of California SFGH Medical Group CurrentSince Jul 30, 2016 Accepting new patients

Locations

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

1001 Potrero Ave
Rm 7M
San Francisco, CA 94110
Phone (415) 206-5612

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480204800000",
    "number": "1962848986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "510-647-8436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "BROOKE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-16",
        "last_updated": "2016-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "27866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.