Active NPI
Brenna Rose Connolly, PSY.D.
- Psychologist
- Redwood City, CA
National Provider Identifier
1992955967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY 22175
- Practice address
- 2824 Hopkins Ave
Redwood City, CA 94062-2839 - Phone
- (209) 607-8463
- NPI assigned
- Sep 25, 2008
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY 22175 | CA | Primary |
Addresses
Primary practice location
2824 Hopkins Ave
Redwood City, CA 94062-2839
Mailing address
2824 Hopkins Ave
Redwood City, CA 94062-2839
Phone (209) 607-8463
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 22175 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222300800000",
"number": "1992955967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2824 HOPKINS AVE",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940622839",
"telephone_number": "209-607-8463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2824 HOPKINS AVE",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940622839",
"telephone_number": "209-607-8463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNOLLY",
"first_name": "BRENNA",
"middle_name": "ROSE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-25",
"last_updated": "2008-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY 22175",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redwood City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.