Individual provider Active NPI

Tricia Lynn Duncan-Hassel, PSY.D.

  • Clinical Psychologist
  • Glendora, CA
National Provider Identifier
1104993898
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY19604 Issued in CA
Practice address
410 S Glendora Ave
Ste 130
Glendora, CA 91741-6207
Phone
(626) 600-8601
Fax
(626) 852-5757
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

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 PSY19604 CA Primary

Addresses

Primary practice location

410 S Glendora Ave
Ste 130
Glendora, CA 91741-6207

Mailing address

410 S Glendora Ave
Ste 130
Glendora, CA 91741-6207
Phone (626) 600-8601

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
I20041005000760 CA Practitioner - Clinical Psychologist 9638138738 Practice locations: Covina, CA; Glendora, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1161 E Covina Blvd
Aurora Charter Oak Hospital
Covina, CA 91724-1523
Phone (626) 600-8601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19604CAMDAddiction (Substance Use Disorder) Counselor
PSY19604CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1104993898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 S GLENDORA AVE",
            "address_2": "STE 130",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917416207",
            "telephone_number": "626-600-8601",
            "fax_number": "626-852-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S GLENDORA AVE",
            "address_2": "STE 130",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917416207",
            "telephone_number": "626-600-8601",
            "fax_number": "626-852-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN-HASSEL",
        "first_name": "TRICIA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY19604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.