Individual provider Active NPI

Richard James Ault, PH.D.

  • Clinical Psychologist
  • Claremont, CA
National Provider Identifier
1093870792
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY13636 Issued in CA
Practice address
2511 N Mountain Ave
Claremont, CA 91711-1545
Phone
(909) 624-4164
Fax
(909) 621-0380
NPI assigned
Dec 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PSY13636 CA Primary

Addresses

Primary practice location

2511 N Mountain Ave
Claremont, CA 91711-1545

Mailing address

2511 N Mountain Ave
Claremont, CA 91711-1545
Phone (909) 624-4164

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
I20111230000329 CA Practitioner - Clinical Psychologist 4789850496 Practice locations: Claremont, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

250 W 1St St
Suite 352
Claremont, CA 91711-1545
Phone (909) 624-4164

2511 N Mountain Ave
Claremont, CA 91711-1545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY13636CAMDClinical Psychologist
13636CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1167004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093870792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 N MOUNTAIN AVE",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917111545",
            "telephone_number": "909-624-4164",
            "fax_number": "909-621-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 N MOUNTAIN AVE",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917111545",
            "telephone_number": "909-624-4164",
            "fax_number": "909-621-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AULT",
        "first_name": "RICHARD",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremont, CA

Sources for this page

Verify at the official NPI Registry.