Mark W. Charles, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY30407 Issued in CA

Practice address

34930 Marcia Rd Apt C
Cathedral City, CA 92234-6979

Phone

(414) 322-0333

NPI assigned

Jun 13, 2012

Last updated

Apr 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Daniel D. Shirbroun, PHD, Inc, Psychologist

  • Clinical Psychologist
  • Yucca Valley, CA
  • NPI 1982607784
  NPD (past)

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1104188374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34930 MARCIA RD APT C",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922346979",
            "telephone_number": "414-322-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34930 MARCIA RD APT C",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922346979",
            "telephone_number": "414-322-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "MARK",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-13",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY30407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenny Carr, RD
• Deanne Carroll, RN
• Cathedral City Palms, LLC (Desert Palms Recovery)
• Cathedral Congregate Living, Inc
• Analisa Ambat Cayabyab
• Kylee Chavez, DDS
• Vincent Kim-Thye Chee, D.D.S
• Morgan Chiarantano
• Anne Therese Chicoine, M.S.W L.C.S.W.
• Brandon Soomin Cho, DDS

• Psychologist in Cathedral City, CA
• Providers in Cathedral City, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.