DR. JOELLE I. BROFFMAN (NPI# 1023660552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023660552 |
| Entity Type | Individual |
| Full Name | DR. JOELLE I. BROFFMAN |
| Credential | PSYD |
| Practice Address |
1700 S Amphlett Blvd Ste 201 San Mateo CA 94402-2717 |
| Mailing Address |
3801 Miranda Ave # 116b Palo Alto CA 94304-1290 |
| Practice Telephone | 6504935000 |
| Mailing Telephone | 6504935000 |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2019-07-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | 30413 | CA | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
30413 | CA | Behavioral Health & Social Service Providers |
| Street Address |
1700 S AMPHLETT BLVD STE 201 |
| City | SAN MATEO |
| State | CA |
| Zip Code | 94402-2717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497304224 | Stem Cognitive and Psychological Rehabilitation, Inc. | Clinical Neuropsychologist | 1700 S Amphlett Blvd Ste 201, San Mateo, CA 94402-2717 | 2019-09-04 |
| 1285280073 | Daniel Koehler | Psychologist | 1700 S Amphlett Blvd Ste 201, San Mateo, CA 94402-2717 | 2019-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154227 | Mark Cameron Head | Non-emergency Medical Transport (VAN) | 331 Sonora Drive, San Mateo, CA 94402 | 2020-11-06 |
| 1669032868 | County of San Mateo | Clinic/Center | 222 Paul Scannell Dr., San Mateo, CA 94402 | 2019-06-19 |
| 1417443755 | Suen Leung | Counselor | 800 Edinburgh St, San Mateo, CA 94402 | 2018-07-10 |
| 1760997902 | Blue Lotus Connection | Point of Service | 1700 S Amphlett Blvd, Ste 250b, San Mateo, CA 94402 | 2017-12-11 |
| 1982122503 | Madeline Pielert | Social Worker | 1670 S. Amphlett Blvd. 115, San Mateo, CA 94402 | 2017-09-04 |
| 1629512348 | Travis Woodmansee | Marriage & Family Therapist | 419 S El Dorado St, San Mateo, CA 94402 | 2016-12-14 |
| 1669820858 | Mohan Sundareson | Pediatrics | 1638 South Grant St, San Mateo, CA 94402 | 2016-05-27 |
| 1457712572 | New Life Acupuncture Clinic | Acupuncturist | 1720 South Amphlett Blvd # 168, San Mateo, CA 94402 | 2016-03-17 |
| 1871951434 | Nanami Oba | Physical Therapy Assistant | 20 Bennigton Dr., San Mateo, CA 94402 | 2016-02-10 |
| 1780059733 | Adrianna Cimera | Behavioral Analyst | 1710 South Amphlett Blvd, Suite 314, San Mateo, CA 94402 | 2015-12-02 |
| Find all providers in zip 94402 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982226387 | Elizabeth Sokolik Green | Psychologist | 26 Seville Way, San Mateo, CA 94402-2831 | 2020-05-08 |
| 1306481288 | Andrew Charlton Sweet | Psychologist | 177 Bovet Rd Ste 540, San Mateo, CA 94402-3121 | 2019-11-14 |
| 1265962146 | Soo Uhm | Psychologist | 1010 S El Camino Real Ste A, San Mateo, CA 94402-2802 | 2017-06-14 |
| 1336690924 | Courtney Chappuis Farmer | Psychologist | 87 Lodato Ave, San Mateo, CA 94403-1723 | 2016-10-18 |
| 1730469198 | Ann K Rawley | Psychologist | 2600 S El Camino Real Ste 200, San Mateo, CA 94403-2382 | 2011-08-17 |
| 1104137637 | Marie Sara Rivera Yap | Psychologist | 1720 S Amphlett Blvd Ste 220g, San Mateo, CA 94402-2713 | 2010-06-30 |
| 1235368135 | Patrice Fortune | Psychologist | 63 Bovet Road #221, San Mateo, CA 94402-3104 | 2009-07-13 |
| 1851597058 | Stan Friedman | Psychologist | 100 S Ellsworth Ave Ste 511, San Mateo, CA 94401-3929 | 2007-06-25 |
| 1932303625 | Susan Enochs | Psychologist | 1650 Borel Pl Ste 125, San Mateo, CA 94402-3507 | 2007-06-14 |
| 1184836330 | June Marie Martin | Psychologist | 1100 S. El Camino Real, Suite #3, San Mateo, CA 94402 | 2007-05-03 |
| Find all providers in SAN MATEO | ||||
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| 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.