Individual provider Active NPI

Brian M Chichester, PSY.D., M.P.H.

  • Clinical Psychologist
  • Redlands, CA
National Provider Identifier
1982888533
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 21544 Issued in CA
Practice address
339 Cajon St
Suite B
Redlands, CA 92373-5901
Phone
(909) 363-6263
Fax
(909) 307-6536
NPI assigned
Dec 18, 2007
Last updated
Dec 18, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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 PSY 21544 CA Primary

Addresses

Primary practice location

339 Cajon St
Suite B
Redlands, CA 92373-5901

Mailing address

339 Cajon St
Suite B
Redlands, CA 92373-5901
Phone (909) 363-6263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 21544CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1982888533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 CAJON ST",
            "address_2": "SUITE B",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735901",
            "telephone_number": "909-363-6263",
            "fax_number": "909-307-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 CAJON ST",
            "address_2": "SUITE B",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735901",
            "telephone_number": "909-363-6263",
            "fax_number": "909-307-6536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHICHESTER",
        "first_name": "BRIAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-18",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 21544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

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