Address: 2130 Fulton St., San Francisco, CA 94117

DOMINIQUE BROUSSARD (NPI# 1407431224) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1407431224
Entity Type Individual
Gender Female
Practice Address 2130 Fulton St.
San Francisco
CA 94117
Practice Telephone 5106109599
Mailing Address 4096 Piedmont Ave # 191
CA 94611-5221
Mailing Telephone 5106109599
Certification Date 2021-02-19
Enumeration Date 2021-03-12
Last Update Date 2021-03-12
Is Sole Proprietor Y


Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
Y 103T00000X Psychologist 32386 CA Behavioral Health & Social Service Providers

Office Location

Street Address 2130 FULTON ST.
State CA
Zip Code 94117

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1497231765 Tsz Ching Isaac Chung Counselor - Addiction (Substance Use Disorder) 2020 Hayes Street, San Francisco, CA 94117 2018-07-19
1104319524 Paul Rivas Counselor - Addiction (Substance Use Disorder) 890 Hayes Street, San Francisco, CA 94117 2018-06-11
1396243887 Marka Physiotherapy Inc · Marka Health Clinic/Center - Physical Therapy 480 Upper Ter, San Francisco, CA 94117 2018-01-30
1124219316 Susan Michelle Tibuni-Sanders · Susan Michelle Tibuni Internal Medicine 2235 Geary, 6 Northwest, San Franscico, CA 94117 2007-08-05
1578142238 Lauren Nicole Chester Counselor 2200 Hayes St Fl 6, San Francisco, CA 94117-1013 2021-04-07
1417501347 Kimberly Shadean Wedderburn Counselor 2200 Hayes St Fl 3, San Francisco, CA 94117-1013 2019-07-29
1003430745 Nicolas Hortensi Community Health Worker 50 Shrader St, San Francisco, CA 94117-1015 2020-05-28
1528606092 Tyler Mark Robert Community Health Worker 52 Shrader St, San Francisco, CA 94117-1015 2019-12-16
1629657424 San Francisco Spine Surgeons PC Orthopaedic Surgery 1 Shrader St Ste 600, San Francisco, CA 94117-1018 2021-04-07
1013478676 David Nathanson Student in an Organized Health Care Education/Training Program 450 Stanyan St, San Francisco, CA 94117-1019 2019-03-27
Find all providers in zip 94117

Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Notes: Source: American Psychological Association [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1609451376 Karen Yeh Psychologist 45 Bartlett St Unit 204, San Francisco, CA 94110-2490 2021-03-15
1023602935 Linda Ann Dunn Psychologist 502 Cole St, San Francisco, CA 94117-2806 2021-02-22
1255948600 Kesha Patrice Psychologist 939 Ellis St, San Francisco, CA 94109-7714 2020-09-29
1336758291 Kelsey Thompson Laird Psychologist 1875 Church St, San Francisco, CA 94131-2712 2020-07-27
1265050595 Vida Family Therapy PC Psychologist 100 Montgomery St Ste 750, San Francisco, CA 94104-4302 2020-07-13
1619593274 Francene G Colvin Psychologist 1939 Divisadero, Suite 1, San Francisco, CA 94115 2020-06-19
1427686831 Laura Straus Psychologist 4150 Clement St # 116p, San Francisco, CA 94121-1563 2020-03-31
1962036111 Mary Brady Psychologist 3159 Sacramento St, San Francisco, CA 94115-2005 2020-02-26
1063044535 Grace Jebara Marriage Therapy Inc Psychologist 2169 Union St # 3, San Francisco, CA 94123-4003 2020-02-12
1477190577 Brittany Linton Psychologist 930 Sutter St Apt 402, San Francisco, CA 94109-6095 2019-12-08
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Zip Code 94117

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.