Active NPI
Tamara Sue Brenner, PH.D.
- Clinical Psychologist
- Tustin, CA
National Provider Identifier
1982929360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 19218
- Practice address
- 242 W Main St
Tustin, CA 92780-7723 - Phone
- (714) 612-0241
- NPI assigned
- Mar 29, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 19218 | CA | Primary |
Addresses
Primary practice location
242 W Main St
Tustin, CA 92780-7723
Mailing address
234 E O St
Colton, CA 92324-3466
Phone (714) 612-0241
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 19218 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seneca Family of Agencies | Past | Accepting new patients | |
| Seneca Center | Past | Accepting new patients | |
| Seneca Family of Agencies | Past | Accepting new patients | |
| Rocketship Education Wisconsin Inc. | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Community/Behavioral Health Agency
- Fairfield, CA
- NPI 1699972281
-
- Community/Behavioral Health Agency
- Anaheim, CA
- NPI 1174801690
-
- Community/Behavioral Health Agency
- Santa Rosa, CA
- NPI 1205152733
-
- Local Education Agency (LEA)
- Milwaukee, WI
- NPI 1275964025
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350864000000",
"number": "1982929360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "234 E O ST",
"city": "COLTON",
"state": "CA",
"postal_code": "923243466",
"telephone_number": "714-612-0241",
"fax_number": "714-516-9141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "242 W MAIN ST",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927807723",
"telephone_number": "714-612-0241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNER",
"first_name": "TAMARA",
"middle_name": "SUE",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-29",
"last_updated": "2012-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 19218",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.