Individual provider Active NPI

Stefanie M Tweedly, PSY.D.

  • Clinical Psychologist
  • Newport Beach, CA
National Provider Identifier
1033348230
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY27679 Issued in CA
Practice address
1151 Dove St Ste 130
Newport Beach, CA 92660-2852
Phone
(949) 706-4889
Fax
(949) 258-7799
NPI assigned
Jul 8, 2009
Last updated
May 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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 PSY27679 CA Primary

Addresses

Primary practice location

1151 Dove St Ste 130
Newport Beach, CA 92660-2852

Mailing address

1151 Dove St Ste 130
Newport Beach, CA 92660-2852
Phone (949) 706-4889

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
I20160420001577 CA Practitioner - Clinical Psychologist 4981834611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1151 Dove St
Suite 130
Newport Beach, CA 92660-2852
Phone (949) 706-4889

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY27679CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Better Being Psychological Services Clinical CurrentSince Jan 28, 2022 Accepting new patients

Locations

1151 Dove St
Ste 105
Newport Beach, CA 92660
Phone (949) 723-1993

1151 Dove St
Ste 130
Newport Beach, CA 92660
Phone (949) 706-4889

1601 Dove St
Ste 193
Newport Beach, CA 92660
Phone (949) 424-4083

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1033348230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 DOVE ST STE 130",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602852",
            "telephone_number": "949-706-4889",
            "fax_number": "949-258-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 DOVE ST STE 130",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602852",
            "telephone_number": "949-706-4889",
            "fax_number": "949-258-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TWEEDLY",
        "first_name": "STEFANIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-08",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.