Individual provider Active NPI

Michael Epstein

  • Forensic Psychologist
  • San Diego, CA
National Provider Identifier
1104975028
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic PsychologistTaxonomy code 103TF0200X
License
33435 Issued in CA
Practice address
12625 High Bluff Dr Ste 216
San Diego, CA 92130-2054
Phone
(619) 952-5321
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychologist 103TF0200X 33435 CA Primary

Addresses

Primary practice location

12625 High Bluff Dr Ste 216
San Diego, CA 92130-2054

Mailing address

7506 Garden Ter Apt 201
San Diego, CA 92127-3611
Phone (619) 952-5321

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
I20240826004218 CA Practitioner - Clinical Psychologist 2163961871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Halliday Center for Psychotherapy and Wellness, IncGroup PAC ID 3375767437, 10 clinicians

Practice addresses (Care Compare)

12625 High Bluff Dr
Suite 216
San Diego, CA 92130-2054
Phone (760) 635-3310

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34435CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
The Halliday Center for Psychotherapy and Wellness, Inc. CurrentSince Jun 14, 2024 Accepting new patients

Locations

355 Santa Fe Dr
Ste 200
Encinitas, CA 92024
Phone (760) 473-3235

12625 High Bluff Dr
Ste 216
San Diego, CA 92130
Phone (619) 952-5321

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1104975028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7506 GARDEN TER APT 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921273611",
            "telephone_number": "619-952-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12625 HIGH BLUFF DR STE 216",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302054",
            "telephone_number": "619-952-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPSTEIN",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "33435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.