Individual provider Active NPI

Rodger Stacy Questin, PHD

  • Psychologist
  • San Diego, CA
National Provider Identifier
1003246364
Registry record updated Nov 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
31181 Issued in CA
Practice address
3702 4TH Ave
San Diego, CA 92103-4203
Phone
(760) 607-7257
NPI assigned
Nov 22, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2019

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 31181 CA
Student in an Organized Health Care Education/Training Program 390200000X
Psychologist 103T00000X 31181 CA Primary

Addresses

Primary practice location

3702 4TH Ave
San Diego, CA 92103-4203

Mailing address

3702 4TH Ave
San Diego, CA 92103-4203

Other practice location 1

1625 Schrader Blvd
Los Angeles, CA 90028-6213
Phone (323) 993-7480

Other practice location 2

3534 5th Ave Unit 724
San Diego, CA 92103-5017
Phone (310) 351-6113

Other practice location 3

440 Upas St Apt 402
San Diego, CA 92103-4919
Phone (310) 351-6113

Other identifiers 1

IdentifierTypeStateIssuer
01261511MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
31181CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Rodger Stacy Questin, Psychologist P.C. Psychologist CurrentSince Dec 1, 2019 Accepting new patients
Circadian Psychological Services Inc CurrentSince Sep 1, 2019 Accepting new patients

Organizations & group practices 2

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": "1385078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574553600000",
    "number": "1003246364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034203",
            "telephone_number": "760-607-7257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1625 Schrader Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900286213",
            "country_code": "US",
            "telephone_number": "323-993-7480",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3534 5th Ave Unit 724",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921035017",
            "country_code": "US",
            "telephone_number": "310-351-6113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "440 Upas St Apt 402",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921034919",
            "country_code": "US",
            "telephone_number": "310-351-6113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUESTIN",
        "first_name": "RODGER",
        "middle_name": "STACY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-22",
        "last_updated": "2019-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "31181",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "31181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01261511",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.