Individual provider Active NPI

Tyler Devin Hinds, MFTI

  • Clinical Psychologist
  • Santa Ana, CA
National Provider Identifier
1013116094
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSB31322 Issued in CA
Practice address
1200 N Main St Ste 100B
Santa Ana, CA 92701-3630
Phone
(714) 480-6650
NPI assigned
Jul 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 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 PSB31322 CA Primary

Addresses

Primary practice location

1200 N Main St Ste 100B
Santa Ana, CA 92701-3630

Mailing address

33 Meadowood
Aliso Viejo, CA 92656-1548
Phone (310) 945-6567

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
I20240712000547 CA Practitioner - Marriage and Family Therapist 9436694668 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSB31322CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 28, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 28, 2024 Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

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": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1013116094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 MEADOWOOD",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926561548",
            "telephone_number": "310-945-6567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N MAIN ST STE 100B",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927013630",
            "telephone_number": "714-480-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINDS",
        "first_name": "TYLER",
        "middle_name": "DEVIN",
        "name_prefix": "Dr.",
        "credential": "MFTI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB31322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.