DR. DOMINIQUE BROUSSARD
NPI 1407431224
Psychologist in San Francisco, CA

Active since March 12, 2021
2130 FULTON ST., SAN FRANCISCO, CA 94117(510) 610-9599 Get Directions Write a Review

NPPES record last updated: March 12, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Dr. Dominique Broussard NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DOMINIQUE BROUSSARD (NPI 1407431224) is an individual psychologist in San Francisco, California, licensed in California (32386) and active in the NPI registry since March 2021.

NPPES Registry Identity

NPI1407431224
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. DOMINIQUE BROUSSARD
Location Address2130 FULTON ST.San Francisco, CA 94117
Mailing Address4096 Piedmont Ave # 191Oakland, CA 94611-5221 · (510) 610-9599
Sole ProprietorYes
Enumeration DateMarch 12, 2021
NPPES CertifiedFebruary 19, 2021
NPI 1407431224 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in CA · 32386
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.
2130 FULTON ST., San Francisco, CA 94117

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dominique Broussard's NPI number?

The NPI number for Dominique Broussard is 1407431224. It was assigned to this individual provider in the NPPES registry on March 12, 2021.

Where is Dominique Broussard located?

Dominique Broussard practices at 2130 Fulton St., San Francisco, CA 94117. The listed phone number is (510) 610-9599.

What is Dominique Broussard's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

When was this NPI record last updated?

The NPPES record for Dominique Broussard was last updated on March 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.