Active NPI
Cecily A Resnick, PHD
- Clinical Psychologist
- Encinitas, CA
National Provider Identifier
1023122579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY16956
- Practice address
- 1991 Village Park Way Ste 150
Encinitas, CA 92024-1940 - Phone
- (760) 445-3737
- Fax
- (760) 944-1501
- NPI assigned
- Aug 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY16956 | CA | Primary |
Addresses
Primary practice location
1991 Village Park Way Ste 150
Encinitas, CA 92024-1940
Mailing address
PO Box 235755
Encinitas, CA 92023-5755
Phone (760) 445-3737
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY16956 | Other | CA | PHD |
| PSY169560 | Medicaid | CA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040224000998 | CA | Practitioner - Clinical Psychologist | 5496641714 | Practice locations: Encinitas, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY16956 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344470400000",
"number": "1023122579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 235755",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "920235755",
"telephone_number": "760-445-3737",
"fax_number": "760-944-1501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1991 VILLAGE PARK WAY STE 150",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "920241940",
"telephone_number": "760-445-3737",
"fax_number": "760-944-1501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RESNICK",
"first_name": "CECILY",
"middle_name": "A",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-19",
"last_updated": "2012-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY16956",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHD",
"identifier": "PSY16956",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY169560",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Encinitas, CA
- Alison Shannon Reid-Bretell, L.AC.
- Jack Reingold, D.P.M.
- Robert Allen Reiss, M.D.
- Relish Life Practitioners Inc
- Renee M. Dupont, MD, Inc
- Restore Family Therapy, Inc.
- Retina Institute of California Medical Group, a California Medical Par
- Retina San Diego
- Wendy Diane Retzer, MPT
- Marla Flores Reves, MFT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.