DR. BRIAN VANFOSSEN – Clinical Psychologist, NPI 1396072500

DR. BRIAN VANFOSSEN is a healthcare provider. based in San diego, California. specializing in CLINICAL PSYCHOLOGIST. They hold a License No. PY60013796 (WA). The NPI Number for DR. BRIAN VANFOSSEN is 1396072500

Main info

Male
Sole Proprietor
20 Years Of Experience
Accepts Medicare Assignment
Name
DR. BRIAN VANFOSSEN
NPI
1396072500
Phone
(619) 325-1161
Address
3434 MIDWAY DR STE 2001
Enumeration Date
9 November 2009
Last Update Date
8 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6193251161
Graduation Year
2006 (20 years ago)
PAC ID
8325179609
Group Practice PAC ID
8123917713
Professional Enrollment ID
I20100630000595
Address ID
CA921104924SA3434XDRXX303
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience70
Completeness75
Years active:16State licenses:2Digital endpointsOther names

4,434 CLINICAL PSYCHOLOGIST in CA

Provider Addresses for DR. BRIAN VANFOSSEN

  • 3434 MIDWAY DR STE 2001

    SAN DIEGO, CA 921104924

    Phone: (619) 325-1161

    Fax: (619) 325-1717

    Type: Mailing

  • West Jayne Avenue, Coalinga, Fresno County, California, United States

    COALINGA, CA 932109503

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-01-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100630000595IClinical PsychologistCATBD
I20260120000599IClinical PsychologistFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92110)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8123917713View full group profile
NameSpecialtyState
Physical Medicine And Rehabilitation, Pain ManagementAZ
-CA
-CA
-CA
-CA
Nurse PractitionerCA
-CA
Clinical PsychologistCA
-CA
Neurology, Pain ManagementCA

Reviews

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Frequently asked questions

Can I use this page to confirm DR. BRIAN VANFOSSEN's NPI?
Yes. DR. BRIAN VANFOSSEN is listed with NPI 1396072500 in the public NPI dataset.
Can I rely on DR. BRIAN VANFOSSEN being an active provider?
As of the registry snapshot, DR. BRIAN VANFOSSEN is marked active.
What is DR. BRIAN VANFOSSEN's primary classification?
Clinical Psychologist is the headline specialty for DR. BRIAN VANFOSSEN here. Clinical services aligned with this taxonomy classification.
Where is DR. BRIAN VANFOSSEN based?
DR. BRIAN VANFOSSEN is tied to San Diego, California in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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