Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

CHARLES P BRODERICK PHD
NPI 1407808280
Clinical Neuropsychologist in Atascadero, CA

Q: What is Charles Broderick's NPI number?

The NPI number for Charles Broderick is 1407808280. It was assigned to this individual provider in the NPPES registry on May 17, 2006.

Q: What is Charles Broderick's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Q: When was this NPI record last updated?

The NPPES record for Charles Broderick was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 25 days 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.

Active since May 17, 2006

10333 EL CAMINO REAL, ATASCADERO, CA 93423(805) 468-2000(805) 466-6011 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Charles P Broderick Phd NPPES

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

CHARLES P BRODERICK PHD (NPI 1407808280) is an individual clinical neuropsychologist in Atascadero, California, licensed in California (PSY17352) and active in the NPI registry since May 2006.

NPPES Registry Identity

NPI1407808280

Entity TypeIndividualMale

Primary Taxonomy103G00000X

Provider Legal NameCHARLES P BRODERICKCredential: PHD

Location Address10333 EL CAMINO REALAtascadero, CA 93423-7001

Mailing Address1600 9th St, Room 205 Mailstop 2 3Sacramento, CA 95814-6414 · (916) 654-2431 · Fax (916) 954-3186

Phone(805) 468-2000

Fax(805) 466-6011

Sole ProprietorNo

Enumeration DateMay 17, 2006

Last NPPES UpdateJuly 13, 2026

✔ NPI 1407808280 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

License✔ Licensed in CA · PSY17352

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

10333 EL CAMINO REAL, Atascadero, CA 93423

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEFFREY FRANZ TEUBER PHD

Psychologist (Intellectual and Developmental Disabilities)