Individual provider Active NPI

Susan Quartarone, PSY.D.

  • Clinical Psychologist
  • Corona, CA
National Provider Identifier
1053544965
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
27225 Issued in CA
Practice address
4160 Temescal Canyon Rd Ste 205
Corona, CA 92883-4624
Phone
(858) 279-1223
NPI assigned
Aug 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 27225 CA Primary
Psychologist 103T00000X

Addresses

Primary practice location

4160 Temescal Canyon Rd Ste 205
Corona, CA 92883-4624

Mailing address

4160 Temescal Canyon Rd Ste 205
Corona, CA 92883-4624

Other practice location 1

1215 W West Covina Pkwy
West Covina, CA 91790-2815
Phone (626) 974-0770

Other names 1

  • Dr. Susan Chavarela Former name

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
I20240827002586 CA Practitioner - Clinical Psychologist 1052850625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orange County Health Psychologists IncGroup PAC ID 4688990260, 59 clinicians

Practice addresses (Care Compare)

15635 Alton Pkwy
Suite 350
Irvine, CA 92618-7333
Phone (949) 528-6300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27225CAMDClinical Psychologist

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": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1053544965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 TEMESCAL CANYON RD STE 205",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928834624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 TEMESCAL CANYON RD STE 205",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928834624",
            "telephone_number": "858-279-1223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 W West Covina Pkwy",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917902815",
            "country_code": "US",
            "telephone_number": "626-974-0770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUARTARONE",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-26",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "27225",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "CHAVARELA",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.