Carey Sherilyn Incledon

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY31538 Issued in CA

Practice address

1101 Dove St Ste 190
Newport Beach, CA 92660-2827

Phone

(949) 630-0630

Fax

(949) 688-5577

NPI assigned

Aug 14, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Sherilyn Marie Bauer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Insight Psychology Center, Inc.

  • Psychologist
  • Newport Beach, CA
  • NPI 1043842974
  NPD Authorized official

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

{
    "created_epoch": "1439510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580601600000",
    "number": "1023484979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4533 MACARTHUR BLVD STE 5100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602059",
            "telephone_number": "949-466-8686",
            "fax_number": "949-688-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 DOVE ST STE 190",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602827",
            "telephone_number": "949-630-0630",
            "fax_number": "949-688-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INCLEDON",
        "first_name": "CAREY",
        "middle_name": "SHERILYN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-14",
        "last_updated": "2020-02-02",
        "certification_date": "2020-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY31538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERILYN",
            "last_name": "BAUER",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michelle Beth Iankowitz
• John Mina Ibrahim, MD
• Diane Ilan, M.F.T.
• Hayley Janelle Immel
• In Home Care Solutions
• Independence Home Care, Inc.
• Christopher W Ingalls, PHD
• Kayla Iniguez
• Injured Workers Medical Group, Inc.
• Jennifer Blair Inman

• Psychologist in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2020; 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.