Individual provider Active NPI

Joel Samaniego, PSYD

  • Clinical Psychologist
  • Temecula, CA
National Provider Identifier
1003220500
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY35416 Issued in CA
Practice address
41715 Enterprise Cir N Ste 205
Temecula, CA 92590-5623
Phone
(915) 276-7691
NPI assigned
Jun 12, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY35416 CA Primary
Counselor 101Y00000X
Psychologist 103T00000X

Addresses

Primary practice location

41715 Enterprise Cir N Ste 205
Temecula, CA 92590-5623

Mailing address

41715 Enterprise Cir N Ste 205
Temecula, CA 92590-5623
Phone (915) 276-7691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250218003189 CA Practitioner - Clinical Psychologist 1456871664 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY35416CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Serene Health CurrentSince Nov 7, 2024 Accepting new patients
Serene Health Ipa CurrentSince Nov 7, 2024 Accepting new patients

Locations

9265 Sky Park Ct
Ste 100
San Diego, CA 92123
Phone (619) 329-4483

4849 Ronson Ct
Ste 207
San Diego, CA 92111
Phone (619) 329-4483

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1003220500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41715 ENTERPRISE CIR N STE 205",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925905623",
            "telephone_number": "915-276-7691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41715 ENTERPRISE CIR N STE 205",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925905623",
            "telephone_number": "915-276-7691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMANIEGO",
        "first_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY35416",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.