Michael I Callis, PH.D., MSCP
Individual provider Active NPI Clinical Psychologist · Orcutt, CA
NPI 1104156884 · NPPES record last updated Jan 3, 2010
Key facts
- NPI
- 1104156884
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 19292 (CA)
- Practice address
- 4610 Cherry Ave
Orcutt, CA 93455-3830 - Phone
- (805) 868-0471
- NPI assigned
- Jan 3, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19292 | CA | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 19292 | CA | |
| Clinical Psychologist | 103TC0700X | 19292 | CA | Yes |
| Health Service Psychologist | 103TH0100X | 19292 | CA |
Addresses
Primary practice location
4610 Cherry Ave
Orcutt, CA 93455-3830
Mailing address
4610 Cherry Ave
Orcutt, CA 93455-3830
Phone (805) 868-0471
Other providers in Orcutt, CA
- Lawrence Beall
- Bendele Behavior Health
- Bendele Family Therapy, Inc
- Candace Curran Bendele
- Connor Bentley
- Moises Caro
- Mikaela Carrillo
- Casa del Mar Group Home
- Eric Castle
- Susan R Catron
All providers in Orcutt, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.