Angelo Colaiacovo, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

34833 Issued in CA

Practice address

2737 W Cecil Ave
Delano, CA 93215-1821

Phone

(661) 721-2345

NPI assigned

Aug 17, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Guided Growth Therapy Group a Psychology Corporation 9 clinicians

Guided Growth Therapy Group 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Guided Growth Therapy Group

  • Psychologist
  • Bakersfield, CA
  • NPI 1912766841

  CA, Psychologist

  Medicare reassignment Care Compare group NPD
• Guided Growth Therapy Group a Psychology Corporation

  • Clinical Psychologist
  • Bakersfield, CA
  • NPI 1073303855

  CA, Clinical

  Medicare reassignment Care Compare group NPD
• Corrections and Rehabilitation-Headquarters

  • Pharmacy
  • Lancaster, CA
  • NPI 1558996371
  NPD
• Corrections and Rehabilitation-Headquarters

  • Pharmacy
  • Delano, CA
  • NPI 1942835756
  NPD
• North Kern State Prison

  • Prison Health Clinic/Center
  • Delano, CA
  • NPI 1710350384
  NPD (past)

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1003428558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44750 60TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935367619",
            "telephone_number": "661-729-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2737 W CECIL AVE",
            "city": "DELANO",
            "state": "CA",
            "postal_code": "932151821",
            "telephone_number": "661-721-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Corporate Center Dr Ste 650",
            "address_purpose": "LOCATION",
            "city": "Monterey Park",
            "state": "CA",
            "postal_code": "917547639",
            "country_code": "US",
            "telephone_number": "626-966-1776",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44750 60th St W",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "CA",
            "postal_code": "935367619",
            "country_code": "US",
            "telephone_number": "661-729-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLAIACOVO",
        "first_name": "ANGELO",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-17",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSB94025373",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB94025373",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "34833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Glynn Michael Cooper, CRNA
• Donald E Cornforth, MD

• All providers in Delano, CA
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.