Individual provider Active NPI

Ami Israel Student, PSY.D.

  • Clinical Psychologist
  • Rancho Mirage, CA
National Provider Identifier
1063725794
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
27086 Issued in CA
Practice address
39900 Desert Sun Dr
Rancho Mirage, CA 92270-3607
Phone
(213) 465-0040
NPI assigned
Jul 22, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 27086 CA Primary
Clinical Psychologist 103TC0700X 028135 NY
Clinical Psychologist 103TC0700X 202862 ID
Clinical Psychologist 103TC0700X 3673 OR

Addresses

Primary practice location

39900 Desert Sun Dr
Rancho Mirage, CA 92270-3607

Mailing address

42440 Bob Hope Dr Suite 1
#150
Rancho Mirage, CA 92270
Phone (213) 465-0040

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
I20250227001609 CA Practitioner - Clinical Psychologist 4789104266 Practice locations: Rancho Mirage, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
202862IDMDClinical Psychologist
028135NYMDClinical Psychologist
3673ORMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1063725794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42440 BOB HOPE DR SUITE 1",
            "address_2": "#150",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "92270",
            "telephone_number": "213-465-0040",
            "fax_number": "949-739-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39900 DESERT SUN DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703607",
            "telephone_number": "213-465-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUDENT",
        "first_name": "AMI",
        "middle_name": "ISRAEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-22",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "27086",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "028135",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ID",
            "license": "202862",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "3673",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.