Active NPI
Jessica Borelli, PH.D.
- Clinical Psychologist
- Claremont, CA
National Provider Identifier
1982965471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 23547
- Practice address
- 647 N College Way
Claremont, CA 91711-4440 - Phone
- (909) 607-3757
- NPI assigned
- May 31, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 23547 | CA | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X |
Addresses
Primary practice location
647 N College Way
Claremont, CA 91711-4440
Mailing address
219 N Indian Hill Blvd
Suite 202a
Claremont, CA 91711-4644
Phone (909) 607-3757
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23547 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338422400000",
"number": "1982965471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "219 N INDIAN HILL BLVD",
"address_2": "SUITE 202A",
"city": "CLAREMONT",
"state": "CA",
"postal_code": "917114644",
"telephone_number": "909-607-3757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "647 N COLLEGE WAY",
"city": "CLAREMONT",
"state": "CA",
"postal_code": "917114440",
"telephone_number": "909-607-3757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORELLI",
"first_name": "JESSICA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-31",
"last_updated": "2012-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "23547",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Claremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.