Individual provider Active NPI

Rigoverto Cabrera Briceno, PH.D.

  • Clinical Psychologist
  • Lynwood, CA
National Provider Identifier
1003824103
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY13413 Issued in CA
Practice address
3737 Martin Luther King Jr Blvd
#385
Lynwood, CA 90262-3513
Phone
(310) 635-5481
Fax
(310) 635-9512
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY13413 CA Primary

Addresses

Primary practice location

3737 Martin Luther King Jr Blvd
#385
Lynwood, CA 90262-3513

Mailing address

3737 Martin Luther King Jr Blvd
#385
Lynwood, CA 90262-3513
Phone (310) 635-5481

Other identifiers 1

IdentifierTypeStateIssuer
PSY134130MedicaidCA

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY13413CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1003824103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 MARTIN LUTHER KING JR BLVD",
            "address_2": "#385",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623513",
            "telephone_number": "310-635-5481",
            "fax_number": "310-635-9512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 MARTIN LUTHER KING JR BLVD",
            "address_2": "#385",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623513",
            "telephone_number": "310-635-5481",
            "fax_number": "310-635-9512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICENO",
        "first_name": "RIGOVERTO",
        "middle_name": "CABRERA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY134130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.