Individual provider Active NPI

Sheree Beth Riley Violon, PSY.D.

  • Psychologist
  • Orange, CA
National Provider Identifier
1063606911
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY23791 Issued in CA
Practice address
1439 E Chapman Ave
Orange, CA 92866-2228
Phone
(818) 631-4215
Fax
(949) 537-3235
NPI assigned
Sep 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY23791 CA Primary

Addresses

Primary practice location

1439 E Chapman Ave
Orange, CA 92866-2228

Mailing address

1439 E Chapman Ave
Orange, CA 92866-2228
Phone (818) 631-4215

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
I20110407000392 CA Practitioner - Clinical Psychologist 9032393533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1439 E Chapman Ave
Orange, CA 92866-2228
Phone (818) 631-4215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY23791CAMDPsychologist

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1063606911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1439 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928662228",
            "telephone_number": "818-631-4215",
            "fax_number": "949-537-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1439 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928662228",
            "telephone_number": "818-631-4215",
            "fax_number": "949-537-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY VIOLON",
        "first_name": "SHEREE",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY23791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.