Individual provider Active NPI

Christina Mary Sanner, PH.D.

  • Clinical Psychologist
  • Round Rock, TX
National Provider Identifier
1033373931
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
37781 Issued in TX
Practice address
1 Chisholm Trail Rd Ste 450
Round Rock, TX 78681-5094
Phone
(254) 688-5329
Fax
(254) 688-5329
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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 37781 TX Primary

Addresses

Primary practice location

1 Chisholm Trail Rd Ste 450
Round Rock, TX 78681-5094

Mailing address

1 Chisholm Trail Rd Ste 450
Round Rock, TX 78681-5094
Phone (254) 688-5329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240612001436 TX Practitioner - Clinical Psychologist 0143463836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Chisholm Trail Rd
Suite 450
Round Rock, TX 78681-5008
Phone (318) 451-2137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
37781TXMDDentist
454NEMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Somatic Regulation & Psychological Services CurrentSince Apr 20, 2024 Accepting new patients

Locations

1 Chisholm Trail Rd
Ste 450
Round Rock, TX 78681
Phone (512) 862-7200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1033373931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHISHOLM TRAIL RD STE 450",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786815094",
            "telephone_number": "254-688-5329",
            "fax_number": "254-688-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHISHOLM TRAIL RD STE 450",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786815094",
            "telephone_number": "254-688-5329",
            "fax_number": "254-688-5329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANNER",
        "first_name": "CHRISTINA",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "37781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.