Individual provider Active NPI

Deborah Lynn Chiddix, PSY.D.

  • Clinical Psychologist
  • Santa Rosa, CA
National Provider Identifier
1043389000
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 24232 Issued in CA
Practice address
434 Earle St
Santa Rosa, CA 95404-5413
Phone
(707) 696-6620
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2026

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 PSY 24232 CA Primary

Addresses

Primary practice location

434 Earle St
Santa Rosa, CA 95404-5413

Mailing address

434 Earle St
Santa Rosa, CA 95404-5413
Phone (707) 696-7816

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
I20140508001587 CA Practitioner - Clinical Psychologist 2961635388 Practice locations: Santa Rosa, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

621 Cherry St
Santa Rosa, CA 95404-4202
Phone (707) 696-7816

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 24232CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Performance and Family Counseling Inc PastSince Jan 19, 2025 Accepting new patients

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1043389000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 EARLE ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954045413",
            "telephone_number": "707-696-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 EARLE ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954045413",
            "telephone_number": "707-696-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIDDIX",
        "first_name": "DEBORAH",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 24232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.