Dr. Jody Edwin Debruin, Ph.D.
Psychologist, Clinical in Atascadero, CA. Individual provider (NPI-1).
NPI number1760633523
StatusActive
Last updated in NPPESJul 15, 2013
Details
- NPI
- 1760633523
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jody Edwin Debruin
- Credential
- Ph.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 9, 2008
- Last updated
- Jul 15, 2013
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CLINICAL PSYCHOLOGIST
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 21895 | CA | Yes |
Other names
- Joe Edwin Debruin (Professional Name)
Practice location
10333 El Camino RealAtascadero, CA 93422-5808
Phone 805-468-2000 · Fax 805-468-6011
Mailing address
1600 9th StRoom 150 Fiscal Allocations And Estimates Unit
Sacramento, CA 95814-6414
Phone 916-651-9475 · Fax 916-651-8908
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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